穿孔性消化性溃疡的手术结果86名患者的单一中心体验

V. Oter, M. Yalçın, M. Kafadar, S. Oter
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摘要

目的:目前,根除幽门螺杆菌感染可显著降低消化性溃疡的发病风险。然而,消化性溃疡的并发症,如穿孔或出血的发生率并没有明显降低。本研究的目的是分析86例消化性溃疡穿孔患者的手术治疗效果。材料与方法:选取2012年1月至2017年12月在我院急诊行GrahamÂ网膜贴片手术治疗穿孔性消化性溃疡的86例患者为研究对象。分析了人口统计学、临床资料、诊断研究、手术方法、手术结果、术后并发症和患者随访情况。结果:患者平均年龄(41.57±16.09)岁。86例患者中男性65例(75.6%),女性21例(24.4%)。平均手术时间66.98±18.61分钟。平均住院时间为7.95±2.02。在三个月的随访期间,所有患者都进行了内窥镜检查,没有发现消化性溃疡疾病。结论:GrahamÂ网膜补片修复术仍是治疗消化性溃疡病的有效方法。开放手术治疗消化性溃疡穿孔,术前术后良好的支持性护理可降低并发症发生率,缩短住院时间,降低术后发病率。腹腔镜手术应该在有经验的外科医生在场的情况下进行,并且在有足够的腹腔镜材料的情况下进行。
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The results of perforated peptic ulcer surgery; a single center experience of 86 patients
Objective: At the present time, eradication of the helicobacter pylori infection is dramatically reduced the risk of the peptic ulcer disease. Whereas, complication rate of the peptic ulcer, such as perforations or bleedings have not reduced significantly yet. The aim of the current study is to analysis the surgical treatment outcomes of our experience in 86 patients with peptic ulcer perforation. Material and methods: Between January 2012 and December 2017, 86 patients who were operated emergently for perforated peptic ulcer disease with GrahamÂ’s omental patch procedure in our hospital were included in this study. Demographic, clinical data, diagnostic studies, surgical procedures, operative findings, postoperative complications and patient follow-up were analyzed. Results: The mean age was (41.57±16.09) years. Out of 86 cases there were 65 (75.6%) male patients and 21 (24.4%) female patients. The mean operation time was 66.98±18.61 minutes. The mean hospital stay period was 7.95±2.02. In three months follow- up period, endoscopy was done to all of these patients and peptic ulcer disease was not seen in any of them. Conclusion: Our findings revealed that GrahamÂ’s omental patch repair is still a useful method for perforated peptic ulcer disease. Low complication rates, low duration of hospital stay and also low postoperative morbidity can be achieved with good preoperative and postoperative supportive care in open surgery for peptic ulcer perforation. Laparoscopic surgery should be performed only in the presence of experienced surgeon and also in the presence of sufficient laparoscopic materials.
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