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目的探讨消化性溃疡急性穿孔的治疗方法,旨在提高Ⅰ期手术治愈的成功率。方法回顾性总结分析手术治疗消化性溃疡急性穿孔208例,其中86例(41.35%)采用胃大部连同病灶切除Ⅰ期治愈,胃肠重建采用BillrothⅠ式吻合18例(20.93%),BillrothⅡ式吻合68例(79.07%),BillrothⅡ式结肠前吻合42例(61.76%),结肠后吻合26例(38.24%)。结果86例中除1例BillrothⅡ式吻合术后发生胃瘫并发症,经保守治疗1个月治愈外,其余患者术后恢复良好,均随访>5年情况良好。结论消化性溃疡急性穿孔的Ⅰ期手术治疗,解决了因溃疡穿孔单行修补术后再次复发穿孔、出血、幽门梗阻、粘连、溃疡恶变而重复手术等问题,缩短了治愈周期,提高了生存质量,减轻了患者的二次手术痛苦和经济负担。
Objective To investigate the treatment of acute perforation of peptic ulcer to improve the success rate of stage Ⅰ operation. Methods A total of 208 cases of peptic ulcer acute perforation were retrospectively analyzed and analyzed. Among them, 86 cases (41.35%) were treated with the most part of the stomach and the first stage of the lesion. 18 cases (20.93%) were treated with Billroth Ⅰ anastomosis, 68 cases (79.07%), 42 cases (61.76%) of Billroth Ⅱ anastomosis and 26 cases (38.24%) of colon after anastomosis. Results In 86 cases, complications of gastroparesis occurred after 1 case of Billroth Ⅱ anastomosis and were cured by conservative treatment for 1 month. All the other cases recovered well after operation for> 5 years. Conclusion The first-stage surgical treatment of peptic ulcer acute perforation solves the problems of recurrence and perforation, hemorrhage, pyloric obstruction, adhesions and malignant transformation of ulcer caused by ulcer perforation, shortens the cure period and improves the quality of life, Reduce the patient’s secondary surgical pain and financial burden.