Boey J, Lee N W, Wong J, Ong G B
Surg Gynecol Obstet. 1982 Aug;155(2):193-6.
To determine the clinical characteristics and outcome of perforated acute ulcers of the duodenum, we prospectively studied 60 patients, 28.3 per cent of all perforations, after closure only. Patients with acute ulcers were significantly older and had a higher hospital mortality than did those with perforated chronic ulcers. Within the first three years following closure, chronic ulcers recurred significantly more often than did acute ulcers. Nevertheless, relapses in patients with acute ulcers were usually symptomatic and, on occasion, necessitated reoperation for complications. Among the acute ulcer group, individuals who had perforated ulcers by the age of 30 years had a significantly increased risk of early recurrence. Due to the higher risk, we suggest that an immediate, definitive operation be evaluated in younger patients with a perforated acute ulcer of the duodenum.
为确定十二指肠急性溃疡穿孔的临床特征及预后，我们仅对60例患者（占所有穿孔病例的28.3%）进行了前瞻性研究，这些患者均仅接受了穿孔闭合术。急性溃疡患者比慢性溃疡穿孔患者年龄显著更大，且医院死亡率更高。在穿孔闭合后的头三年内，慢性溃疡复发的频率显著高于急性溃疡。然而，急性溃疡患者的复发通常有症状，有时因并发症需要再次手术。在急性溃疡组中，30岁前发生溃疡穿孔的个体早期复发风险显著增加。鉴于风险较高，我们建议对患有十二指肠急性溃疡穿孔的年轻患者评估立即进行确定性手术。
