摘要
【目的】探讨胃肠吻合器在胃十二指肠溃疡急性穿孔手术中的应用价值。【方法】2003年6月至2006年6月收治胃十二指肠溃疡急性穿孔病例72例,根据手术中吻合方法分为研究组(吻合器吻合组)和对照组(手工吻合组)。研究组36例,其中十二指肠球部溃疡穿孔28例,胃窦部溃疡穿孔6例,胃小弯溃疡穿孔2例;采用BillrothⅠ术式治疗26例,BillrothⅡ式8例,Roux-en-y胃肠吻合2例。对照组36例,十二指肠球部溃疡穿孔25例,胃窦部溃疡穿孔5例,胃小弯溃疡穿孔6例;采用BillrothⅠ术式治疗20例,BillrothⅡ式12例,Roux-en-y胃肠吻合4例。【结果】研究组手术时间(112.0±21.1min)较对照组(165.0±23.8min)短(P<0.01),术后胃肠功能恢复时间(43.6±5.6h)较对照组(63.6±10.7h)短(P<0.01),术中出血量(130±10mL)较对照组(220±14mL)少(P<0.01),住院时间较对照组短。研究组无吻合口瘘,无吻合口狭窄及出血,对照组发生吻合口狭窄1例、吻合口漏1例、吻合口出血2例,研究组并发症明显低于对照组(P<0.01)。【结论】胃十二指肠溃疡急性穿孔时应用胃肠吻合器行胃大部切除术具有出血少、手术时间短、胃肠功能恢复快、术后并发症少等特点,值得推广应用。
[Objective]To explore the application of the China-made stapler in the operation of acute perforation of gastroduodenal ulcer. [Methods]Seventy two patients with acute perforation of gastroduodenal ulcer were studied and divided into two groups, study group （application stapler） and the control group （by manual anastomosis） according to method of gastrointestinal reconstruction. In study group, 36 cases in which there were 28 perforations of duodenal bulb, 6 perforations of sinus ventriculi and 2 perforations of arcus minor ventriculi ulcer were anastomosed with stapler. And in this group, 26 cases were operated by subtotal gastrectomy of Billroth Ⅰ ,8 cases were operated by Billroth Ⅱ and 2 cases were operated by Roux-en-y stomach intestine anastomose. In control group, 36 cases in which there were 25 perforations of duodenal bulb ulcer, 5 perforations of sinus ventriculi and 6 perforations of arcus minor ventriculi ulcer were anastomosed with manual. And in this group, 20 cases were operated by subtotal gastrectomy of Billroth Ⅰ ,12 cases were operated by Billroth Ⅱ and 4 cases were operated by Roux-en-y stomach intestine anastomose. {Results]Mean time of operation, mean volume of bleeding and mean functional recovery time of stomach intestine were 112.0±21.1 min, 130±10 mL, 43.6±5.6 h respectively in the study group and they were less compared with the control group（165. 0±23.8min,220±14 mL,63. 6±10.7 h）（ P 〈0.01）. One case with anastomotic stenosi, 1 case with leakage and 1 cases with bleeding were found in control group, but no such complications were found in study group. The complications in study group were significantly lower than those in control group （P 〈 0. 01）.[Conclusion]Subtotal gastrectomy with China-made stapler for treating acute perforation of gastroduodenal ulcer has many advantages, such as less bleeding, short time of operation, rapid functional recovery of stomach and intestine, lower cost and higher safe. It was worthy of extending the utilization of China-made stapler in many hospitals.
出处
《医学临床研究》
CAS
2008年第4期667-669,共3页
Journal of Clinical Research
