许瑞云 汪壮流 邱万寿 凌云彪 郑峰 邓美海 中山医科大学附属第三医院普外科(广州.510630) 中国胃肠外科杂志 1999 0 2 1


    关键词：十二指肠溃疡；迷走神经切断术；幽门螺杆菌；奥美拉唑 期刊 zgwcwkzz 0 论著 fur -->


    

摘要 目的 研究十二指肠溃疡穿孔的两种不同疗法——穿孔修补术加近侧胃迷走神经切断术(PGV)与穿孔修补术加奥美拉唑方案的临床疗效。方法 将1994年1月-1996年12月相继入院的48例十二指肠溃疡穿孔患者随机分为A、B两组。A组(21例)在穿孔修补术的基础上，加行PGV。B组(27例)仅作穿孔修补术，术后辅予奥美拉唑方案(即口服奥美拉唑加羟氨苄青霉素加灭滴灵)。术后定期随访。随访结果按Visick标准分级。结果 A组术后半年和2年疗效优良者(VisickⅠ加Ⅱ级)分别为18例(85.7%)和17例(81.0%)，溃疡复发者(VisickⅣ级)分别为1例(4.8%半年)和2例(9.5%2年)。B组术后半年和2年疗效优良者分别为19例(66.7%)和10例(37.0%)，溃疡复发者分别为5例(18.5%)和12例(44.5%)。A组疗效优于B组(P<0.01)。Hp检测，A组术后半年和两年的Hp阳性率分别为81.0%和85.7%(P>0.05)；B组分别为18.5%和51.9%(P<0.01)。结论 十二指肠溃疡穿孔在施行修补术后，应同时加行PGV，以提高对溃疡病的根治效果。

A control study of curative effects of suture plus PGV or suture plus omeprazole-plan for the treatment of duodenal ulcer with acute perforation

Xu Ruiyun, Wang Zhuangliu, Qiu Wanshou, Ling Yunbiao,et al.

    Department of General Surgery,Third Affiliated Hospital,Sun Yat-sen llniversity of Medical Sciences, Guangzhou 510630.

Abstract Objective To Study the curative effects of suture plus PGV and suture plus omeprazole-plan for the treatment of duode nal ulc er with acute perforation. Method 48 patients with duodenal u lcer and acute perforation admitted from Jannary, 1994 to December, 1996 were r andomized into two groups. The patients in group A (21 cases) were treated with SPP, and t he patients in group B (27 cases) with SPO. Postoperative clinical symptoms, end oscopic appearance and detecting for Helicobacter pylori (Hp) were evaluated.Results The curative effect of group A at the time of half yea r s and two years postoperation were 18(85.7%) and 17(81.0%) cases (visick Ⅰ,Ⅱ ), respectively. The group B's curative effect were 19(66.7%) and 10(37.0%) re spectively at time of half years and two years postoperation. In detecting for Hp, there were 17(81.0%) and 18(85.7%) in gorup A (P>0.05) ......