Tønnessen T, Carlsen E
Kirurgisk avdeling Ullevål sykehus 0407 Oslo.
Tidsskr Nor Laegeforen. 2001 Mar 10;121(7):790-2.
We wanted to review patients operated for perforated peptic ulcer at Ullevål University Hospital, Oslo, Norway in the period 1992-1997.
Data from 84 operated patients (43 men) were obtained retrospectively from patient and hospital files. Median age was 69 years (range 20-92 years).
41 patients had perforated duodenal ulcer and 43 had perforated gastric ulcer (pylorus included). Median time from start of symptoms until admission to hospital was 5 hours (range 2-24 hours; n = 40) and from admission to start of surgery 5 hours (range 1 1/2-48 hours; n = 69). 64 out of 74 patients had pneumoperitoneum on preoperative abdominal X-ray examination. 77 patients were operated with rafi and/or tegmentation of the perforation; six patients with Billroth II or Billroth I; one patient was treated with percutaneous drainage. Median duration of surgery was 68 minutes (range 40-240 minutes). Thirteen patients died in hospital. Post-operative complications were recorded in 30 patients.
Early surgical intervention is important to reduce lethality from ulcus perforatum. A patient with clinical peritonitis and suspected perforated peptic ulcer should be operated without time-consuming examinations.
我们想要回顾1992年至1997年期间在挪威奥斯陆的于勒沃尔大学医院接受穿孔性消化性溃疡手术的患者情况。
从患者和医院档案中回顾性获取了84例接受手术患者（43名男性）的数据。中位年龄为69岁（范围20 - 92岁）。
41例患者为十二指肠溃疡穿孔，43例为胃溃疡穿孔（包括幽门）。从症状开始到入院的中位时间为5小时（范围2 - 24小时；n = 40），从入院到开始手术的时间为5小时（范围1.5 - 48小时；n = 69）。74例患者中64例术前腹部X线检查有气腹。77例患者接受了穿孔修补和/或覆盖；6例患者接受了毕Ⅱ式或毕Ⅰ式手术；1例患者接受了经皮引流治疗。中位手术时长为68分钟（范围40 - 240分钟）。13例患者在医院死亡。30例患者记录有术后并发症。
早期手术干预对于降低溃疡穿孔的致死率很重要。患有临床腹膜炎且怀疑有消化性溃疡穿孔的患者应无需进行耗时的检查即接受手术。
