CAJ | 학술논문

目的探讨胃十二指肠溃疡穿孔修补术后近期再穿孔影响因素.方法回顾性分析三家医院近十年胃十二指肠溃疡穿孔修补术后近期再穿孔病例25例,随机抽样未发生近期再穿孔25例,对影响再穿孔的相关因素进行比较.结果影响胃十二指肠溃疡穿孔修补术后近期再穿孔的危险因素有:高龄,年龄≥60岁;存在伴随疾病(糖尿病,肝硬化,肺心病,高血压);穿孔时间长(≥24h);穿孔直径大(≥1cm);穿孔周围存在明显瘢痕.结论对于存在危险因素的病人,应改进手术方法,预防再穿孔.情况允许时,可作胃大部切除.发生再穿孔后,一般可经保守治疗治愈.
목적 탐토위십이지장궤양천공수보술후근기재천공영향인소.방법 회고성분석삼가의원근십년위십이지장궤양천공수보술후근기재천공병례25례,수궤추양미발생근기재천공25례,대영향재천공적상관인소진행비교.결과 영향위십이지장궤양천공수보술후근기재천공적위험인소유:고령,년령≥60세;존재반수질병(당뇨병,간경화,폐심병,고혈압);천공시간장(≥24h);천공직경대(≥1cm);천공주위존재명현반흔.결론 대우존재위험인소적병인,응개진수술방법,예방재천공.정황윤허시,가작위대부절제.발생재천공후,일반가경보수치료치유.
Objective To explore the influencing factors for reperforation after surgical repair of perforated gastroduodenal ulcer. Methods 25 patients with reperforation after repair of perforated gastroduodenal ulcer in three hospitals in the past ten years were analyzed retrospectively;and 25 patients without perforation were randomly selected. The influencing factors of reperforation were compared and then analyzed statistically using the Spss 13.0. P＜0.05 had significant differences. Results The high-risk factors for influencing reperforation were people aged 60 or older;coexiting diseases including diabetes mellitus,cirrhosis,cor pulmonale,and hypertension;prolonged perforation (equal to or longer than 24 hours);larger perforation (diameter equal to or longer than one centimeter);and obvious scars around the perforated area. Conclusions For the high-risk patients,surgical procedures should be improved to prevent reperforation. If the patient conditions are allowed,subtotal gastrectomy can be performed. The patients generally can be cured by palliative treatment after the occurrence of reperforation.