Vachev A N, Adyshirin-Zade E E, Frolova E V, Dergal' S V, Kozlov A A
Eksp Klin Gastroenterol. 2010(2):43-7.
A retrospective analysis of 365 completed patient records received by the duty surgical hospital with perforated gastric ulcer and duodenal ulcer. All the patients were operated on urgently. Diagnosis of purulent peritonitis was set 17% of patients, "serous"--47.4%, "seroplastic"- 35.6%. 75.3%, perform suturing of perforated openings, regardless of the form of peritonitis. The remaining 24.7%--interventions that address as a perforation, and the impact on the pathogenesis of peptic ulcer. When radical surgery, which were performed in selected patients even with purulent peritonitis, deaths were reported. And when suturing the ulcer defect lethality was 14.5%. In this group of patients were comparable in age and severity of general condition. It is concluded that that the operations of suturing perforated ulcers were used unnecessarily broad, and the majority of patients admitted to hospital with a perforated stomach ulcer and duodenum may increase the volume of surgical benefit for radical treatment of complications as well as most of peptic ulcer.
对值班外科医院接收的365份胃溃疡和十二指肠溃疡穿孔完整患者记录进行回顾性分析。所有患者均接受了急诊手术。17%的患者被诊断为化脓性腹膜炎，“浆液性”为47.4%，“浆膜性”为35.6%。75.3%的患者进行了穿孔开口缝合，无论腹膜炎的形式如何。其余24.7%的患者采取了针对穿孔以及对消化性溃疡发病机制产生影响的干预措施。在部分患者（甚至是化脓性腹膜炎患者）进行根治性手术时，出现了死亡病例。而在缝合溃疡缺损时，致死率为14.5%。这组患者在年龄和全身状况严重程度方面具有可比性。得出的结论是，溃疡穿孔缝合手术的应用过于宽泛，大多数因胃溃疡和十二指肠溃疡穿孔入院的患者可能会增加根治并发症以及大多数消化性溃疡手术受益的范围。
