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目的探讨单纯修补配合术后正规内科治疗对胃溃疡急性穿孔的意义。方法对2003—2007年间收治的59例胃溃疡急性穿孔患者的临床资料进行回顾性分析。结果59例均采用穿孔单纯修补术,手术均获得成功,无围手术期死亡,术后轻度并发症3例(5.1%),无再穿孔、大出血等严重并发症。术后给予奥美拉唑20mg口服2次/天,疗程8～12周,若HP阳性同时服用阿莫西林1.0g,克拉霉素0.25g均2次/天,疗程2周。随访54例,随访时间12～36个月,溃疡治愈率和复发率分别为98.1%(53/54)和3.8%(2/53)。结论单纯修补术后辅以正规内科疗法,是治疗胃溃疡急性穿孔的有效手段,可以考虑常规应用。
Objective To explore the significance of simple repair combined with regular medical treatment of acute gastric ulcer perforation. Methods The clinical data of 59 patients with acute gastric ulcer perforation admitted from 2003 to 2007 were analyzed retrospectively. Results All the 59 cases were treated by simple perforation. All the operations were successful. There were no perioperative deaths. Three patients (5.1%) had mild complications after operation. There were no serious complications such as perforation and hemorrhage. After oral administration of omeprazole 20mg 2 times / day for 8 to 12 weeks, if HP positive while taking amoxicillin 1.0g, clarithromycin 0.25g 2 times / day for 2 weeks. Follow-up 54 cases, followed up for 12 to 36 months, the cure rate and recurrence rate of ulcer were 98.1% (53/54) and 3.8% (2/53) respectively. Conclusions Simple repair combined with regular medical therapy is an effective method to treat acute perforation of gastric ulcer and can be considered routinely.