Schein M, Saadia R, Jamieson J, Decker G A
Am Surg. 1986 Oct;52(10):551-4.
During the last 6 years the authors have treated 99 patients with perforated peptic ulcers. Sixty-six patients had perforated pyloro-duodenal ulcers, while 32 patients were treated for perforated gastric ulcers, a ratio of 2:1. This article deals with the gastric ulcers treated by a surgical unit in an urban, 600-bed multidisciplinary hospital. The mean age of the patients was 58.7 years. In 71.8 per cent of the patients, the perforation was the first major manifestation of the ulcer disease. Seven patients (21.8%), all in the high-risk group according to the criteria of Boey et al. died. There was no death among the low-risk patient group. Eleven patients, all high-risk, had excision and/or biopsy of the ulcer followed by simple closure; three of these patients died (27.2%). Twenty patients, of whom seven were in the high-risk group, underwent gastrectomy; three deaths occurred (15%). The authors conclude that the underlying general health of the patient is a major determinant of the outcome following gastric ulcer perforation.
在过去6年中，作者共治疗了99例消化性溃疡穿孔患者。其中66例为幽门十二指肠溃疡穿孔，32例为胃溃疡穿孔，比例为2:1。本文探讨的是一家拥有600张床位的城市多学科医院的外科单元所治疗的胃溃疡穿孔患者。患者的平均年龄为58.7岁。71.8%的患者中，溃疡穿孔是溃疡病的首个主要表现。按照Boey等人的标准，7例患者（21.8%）均属于高危组，最终死亡。低危组患者中无死亡病例。11例高危患者接受了溃疡切除和/或活检，随后进行单纯缝合；其中3例患者死亡（27.2%）。20例患者接受了胃切除术，其中7例属于高危组；发生了3例死亡（15%）。作者得出结论，患者潜在的总体健康状况是胃溃疡穿孔后预后的主要决定因素。
