单纯修补手术与胃大部切除手术治疗胃穿孔的临床分析(1)
[摘要] 目的 探討单纯修补手术与胃大部切除手术治疗胃穿孔的临床。方法 方便选取2015年1月—2018年9月该院收治的100例胃穿孔患者，随机分组。胃大部切除手术组选择胃大部切除手术，单纯修补手术组选择单纯修补手术。分析手术治疗的时间、手术过程的出血水平、手术后住院的时间、下床开始活动的时间;治疗前后患者生活质量sf-36分值、应激指标;并发症。结果 治疗前两组生活质量sf-36分值、应激指标比较，差异无统计学意义(P>0.05);治疗后单纯修补手术组生活质量sf-36分值、应激指标血清皮质醇、去甲肾上腺素(90.24±6.11)分、(54.11±3.34)μg/L、(31.19±2.35)μg/L优于胃大部切除手术组(t=6.834、7.934、8.024，P<0.05)。单纯修补手术组手术治疗的时间、手术过程的出血水平、下床开始活动的时间、手术后住院的时间、(65.02±2.12)min、(81.02±2.15)mL、(34.01±2.21)h、(9.21±1.56)d优于胃大部切除手术组(t=5.356、5.296、6.673、5.756，P<0.05)。单纯修补手术组并发症低于胃大部切除手术组(χ2=6.245，P<0.05)，单纯修补手术组并发症中，1例出现切口感染，1例出现十二指肠残端瘘，总发生2例，发生率是4%。胃大部切除手术组并发症中，4例出现切口感染，4例出现十二指肠残端瘘，2例出现中毒性休克，总发生10例，发生率是20%。结论 胃穿孔患者实施单纯修补手术可获得较好效果，可有效减少创伤和减少并发症，改善患者的生活质量，减轻应激指标和缩短住院的时间。
[关键词] 单纯修补手术;胃大部切除手术;胃穿孔;临床效果
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2019)09(a)-0078-04
[Abstract] Objective To investigate the clinical practice of simple repair surgery and partial gastrectomy for gastric perforation. Methods Convenient selected one hundred patients with gastric perforation were enrolled from January 2015 to September 2018， randomized. The subtotal gastrectomy group underwent partial gastrectomy， and the simple repair surgery group chose simple repair surgery. The time of surgical treatment， the bleeding level during the operation， the time of hospitalization after surgery， the time of getting out of bed， the quality of life sf-36 scores before and after treatment， and the stress index were analyzed. Results The sf-36 scores and stress scores of the two groups before treatment were compared，the difference was not statistically significant(P>0.05). The quality of life sf-36 scores， stress index serum cortisol， norepinephrine (90.24±6.11)points，(54.11±3.34)μg/L，(31.19±2.35)μg/L were superior to the major gastrectomy group(t=6.834， 7.934， 8.024， P<0.05). The time of surgery in the simple repair surgery group， the bleeding level during the operation， the time of getting out of bed， and the time of hospitalization after surgery(65.02±2.12)min， (81.02±2.15)mL，(34.01±2.21)h，(9.21±1.56)d were better than partial gastrectomy group(t=5.356， 5.296， 6.673， 5.756， P<0.05). The complication of the simple repair surgery group was lower than that of the major gastrectomy group(χ2=6.245， P<0.05). Among the complications of the simple repair operation group， 1 case had incision infection and 1 case had duodenal stump fistula， Total incidence occurred in 2 cases， the incidence was 4%. In the complications of the major gastrectomy group， 4 cases had incision infection， 4 cases had duodenal stump fistula， and 2 cases had toxic shock. Total incidence occurred in 10 cases， the incidence rate was 20%. Conclusion Patients with gastric perforation can achieve better results by simple repair surgery， which can effectively reduce trauma and reduce complications， improve patients' quality of life， reduce stress indicators and shorten hospitalization time., 百拇医药(王志晓)
[关键词] 单纯修补手术;胃大部切除手术;胃穿孔;临床效果
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2019)09(a)-0078-04
[Abstract] Objective To investigate the clinical practice of simple repair surgery and partial gastrectomy for gastric perforation. Methods Convenient selected one hundred patients with gastric perforation were enrolled from January 2015 to September 2018， randomized. The subtotal gastrectomy group underwent partial gastrectomy， and the simple repair surgery group chose simple repair surgery. The time of surgical treatment， the bleeding level during the operation， the time of hospitalization after surgery， the time of getting out of bed， the quality of life sf-36 scores before and after treatment， and the stress index were analyzed. Results The sf-36 scores and stress scores of the two groups before treatment were compared，the difference was not statistically significant(P>0.05). The quality of life sf-36 scores， stress index serum cortisol， norepinephrine (90.24±6.11)points，(54.11±3.34)μg/L，(31.19±2.35)μg/L were superior to the major gastrectomy group(t=6.834， 7.934， 8.024， P<0.05). The time of surgery in the simple repair surgery group， the bleeding level during the operation， the time of getting out of bed， and the time of hospitalization after surgery(65.02±2.12)min， (81.02±2.15)mL，(34.01±2.21)h，(9.21±1.56)d were better than partial gastrectomy group(t=5.356， 5.296， 6.673， 5.756， P<0.05). The complication of the simple repair surgery group was lower than that of the major gastrectomy group(χ2=6.245， P<0.05). Among the complications of the simple repair operation group， 1 case had incision infection and 1 case had duodenal stump fistula， Total incidence occurred in 2 cases， the incidence was 4%. In the complications of the major gastrectomy group， 4 cases had incision infection， 4 cases had duodenal stump fistula， and 2 cases had toxic shock. Total incidence occurred in 10 cases， the incidence rate was 20%. Conclusion Patients with gastric perforation can achieve better results by simple repair surgery， which can effectively reduce trauma and reduce complications， improve patients' quality of life， reduce stress indicators and shorten hospitalization time., 百拇医药(王志晓)