论文部分内容阅读
目的:对老年消化性溃疡患者发生急性穿孔后的临床治疗方法进行探讨分析。方法:把我院2010年9月~2012年8月住院的40例老年消化性溃疡急性穿孔病人纳入研究,并对其住院期间的临床资料进行回顾性分析。结果:其中有4例患者行保守治疗,有2例死亡。另外36例患者均行手术治疗,并采取不同的手术方案,主要包括腹腔镜手术和开腹手术,术后给予常规维持酸碱平衡等对症治疗。腹腔镜组有患者24例,开腹组有患者12例。腹腔镜组的住院时间、术中出血量、术后镇痛药比例及胃肠功能恢复时间均低于开腹组,差异有统计学意义(P<0.05)。腹腔镜组手术时间与开腹组手术时间无明显差异(P>0.05)。结论:手术治疗是老年消化性溃疡急性穿孔的主要治疗方法,腹腔镜手术创伤小,安全性高,恢复快,是急性穿孔的首选方法,值得临床推广。
Objective: To investigate the clinical treatment of acute peptic ulcer patients after acute perforation. Methods: 40 elderly patients with acute peptic ulcer admitted to our hospital from September 2010 to August 2012 were enrolled in the study, and their clinical data during hospitalization were analyzed retrospectively. Results: Four of these patients underwent conservative treatment and two died. The other 36 patients underwent surgical treatment, and adopted different surgical protocols, including laparoscopic surgery and laparotomy, postoperative routine maintenance of acid-base balance symptomatic treatment. There were 24 patients in the laparoscopic group and 12 patients in the open group. The length of hospital stay, intraoperative blood loss, postoperative analgesic ratio and gastrointestinal function recovery time in laparoscopic group were significantly lower than those in open group (P <0.05). There was no significant difference between laparoscopic group and laparotomy group (P> 0.05). Conclusion: Surgical treatment is the main treatment for acute perforation of elderly patients with peptic ulcer. Laparoscopic surgery has the advantages of small trauma, high safety and quick recovery. It is the first choice for acute perforation and is worthy of clinical promotion.