目的：观察一期胃大部切除术治疗胃十二指肠溃疡急性穿孔的临床疗效。方法：选取进行胃十二指肠溃疡急性穿孔手术治疗的178例患者为研究对象，随机分为对照组（单纯开腹修补术）89例和试验组（一期胃大部切除术）89例。术后分别观察两组患者的临床疗效并进行统计学分析。结果：术后1~3年，随访观察发现：①试验组的溃疡复发率为10.11%，二次穿孔复发率为6.74%，并发症发生率为8.99%，均低于手术对照组，两组比较差异具有统计学意义（ P<0.05）。②试验组患者对于手术后治疗效果的满意率为94.38%，明显高于对照组的78.65%，两组比较差异有统计学意义（ P<0.05）。结论：一期胃大部切除术治疗胃十二指肠溃疡急性穿孔长期疗效好，患者满意度高，术后溃疡复发率较低，并发症相对于保守治疗组较少，适用于长期急重症患者。%Objective To observe the clinical effects of subtotal gastrectomy for patients of acute gastroduodenal ulcer perforation. Methods 178 cases of acute gastroduodenal ulcer perforation treated by operation were divided into control group( operation on simple clo-sure with open)with 89 cases and treatment group( subtotal gastrectomy)with 89 cases. The clinical effects of two groups were observed and statistical analyzed. Results After 1~3 years follow-up observation:①The ulcer recurrence rate of treatment group was 10. 11%, the second gastric perforation was 6. 74%,the incidence of complication was 8. 99%,all these three data were lower than control group. The difference was statistical significance(P<0. 05). Conclusion The long-term results of subtotal gastrectomy for patients of acute gas-troduodenal ulcer perforation was good. The satisfactory was better. The ulcer recurrence rate and the incidence of complication were lower than traditional treatment. It′s fit for critical patients.
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