林勇 林贤平

    [摘要] 目的 探討及总结巨大消化性溃疡穿孔修补手术处置策略及围手术期疗效。 方法 回顾性选取2014年1月～2020年5月本院采用改良式四步法修补术治疗的巨大消化性良性溃疡穿孔患者20例作为观察组，选取同期实施小穿孔常规修补术治疗直径0.05)，观察组患者术后无一例发生瘘及腹腔脓肿，均进半流质饮食后顺利出院。对照组禁食时间、胃肠减压时间、住院时间、治疗费用少于观察组，差异有统计学意义(P0.05)。 结论 采用改良式四步法修补术治疗巨大消化性溃疡穿孔，临床效果满意，较直径在1.0 cm以下的良性消化性溃疡穿孔患者仅增加禁食时间、胃肠减压时间、住院时间及治疗费用，未增加并发症发生率。

    [关键词] 消化性溃疡穿孔;巨大穿孔;修补术;带蒂大网膜片;围术期

    [中图分类号] R615? ? ? ? ? [文献标识码] B? ? ? ? ? [文章编号] 1673-9701(2020)33-0073-04

    [Abstract] Objective To discuss and summarize the strategy and perioperative curative effect of repair surgery of perforated giant peptic ulcer. Methods A total of 20 cases of perforated giant peptic benign ulcers who were admitted and treated with a modified four-step repair technique in our hospital from January 2014 to May 2020 were reviewed and selected as the observation group. A total of 20 patients with perforated benign peptic ulcer with the diameter less than 1.0 cm undergoing surgery during the same period were selected as the control group. Routine repair of small perforations was performed. The perioperative indicators ......