Saber Aly, Gad Mohammad A, Ellabban Gouda M
Department of General Surgery, Port-Fouad, Port-Said, Egypt.
N Am J Med Sci. 2012 Jan;4(1):35-9. doi: 10.4103/1947-2714.92902.
Conservative treatment was recommended as the treatment of choice in perforated acute peptic ulcer. Here, we adjunct percutaneous peritoneal drainage with nonoperative conservative treatment in high risk elderly patients with perforated duodenal ulcer.
The work was to study the efficacy of percutaneous peritoneal drainage under local anesthesia supported by conservative measures in high risk elderly patients, according to the American Society of Anesthesiologists grading, with perforated duodenal ulcer.
Twenty four high risk patients with age >65 years having associated medical illness with evidence of perforated duodenal ulcer.
The overall morbidity and mortality were comparable with those treated by conservative measures alone.
In high risk patients with perforated peptic ulcer and established peritonitis, percutaneous peritoneal drainage under local anesthesia seems to be effective with least operative trauma and mortality rate.
保守治疗被推荐为急性消化性溃疡穿孔的首选治疗方法。在此，我们对高危老年十二指肠溃疡穿孔患者采用经皮腹腔引流联合非手术保守治疗。
本研究旨在探讨在保守治疗支持下，局部麻醉下行经皮腹腔引流术对美国麻醉医师协会分级为高危的老年十二指肠溃疡穿孔患者的疗效。
24例年龄>65岁、伴有相关内科疾病且有十二指肠溃疡穿孔证据的高危患者。
总体发病率和死亡率与单纯采用保守治疗的患者相当。
对于有消化性溃疡穿孔且已发生腹膜炎的高危患者，局部麻醉下行经皮腹腔引流术似乎有效，手术创伤和死亡率最低。
