消化性溃疡穿孔114例临床分析

【摘要】 目的  总结急性消化性溃疡穿孔的诊治经验，以提高对溃疡病急性穿孔的诊治水平。 方法  对我院2000年1月～2004年4月期间收治的114例消化性溃疡穿孔病人的临床资料进行回顾性分析。 结果  114例消化性溃疡病人中，术前确诊100例，误诊2例，12例根据愈后检查推断。行穿孔修补术99例，胃大部分切除术2例，保守治疗13例。99例穿孔修补术中55例取穿孔周围组织活检，发现1例为腺癌。 结论  术前X线、B超、诊断性腹腔穿刺联合应用可提高穿孔的确诊率，术中活检安全、有效，有利于明确穿孔的性质，明确诊断。

    关键词  消化性溃疡 急性穿孔 组织活检 气腹征
  
    Clinical analysis of114perforating cases with peptic ulcer.

    【Abstract】 Objective To summer up the experience of diagnosis and surgical treatment for acute perforating peptic ulcer so as to improve the relevant level.Methods The clinical data of114perforating peptic ulcer cases hos-pitalized in our hospital from January2000to April2004were retrospectively analyzed.Results Among the114per-forating cases with peptic ulcer，100cases were definitely diagnosed preoperatively，2cases were misdiagnosed，12cases were deduced according to the post-cure examinations.Repairing were done in99cases，2cases were done by partial gastrectomy，13cases were treated with medicine.Among99cases done by perforating neoplasty，biopsy were done around the perforation in55cases，adenocarcinoma was detected in1case.Conclusion Postoperative combined X-ray，B-ultrasound and diagnostic abdominal paracentesis could improve the diagnostic rate of perforation，intra-operative biopsy around the perforation plus stucture of perforation were safe and effective，and could make sure of the property of perforation.

    Key words peptic ulcer acute perforation biopsy pneumoperitoneum

    消化性溃疡穿孔是胃十二肠溃疡常见的严重并发症，也是外科常见急腹症之一。我院2000年1月～2004年4月期间共收治消化性溃疡穿孔病人114例。现就其诊断、治疗等分析讨论如下。

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