经缝合折叠术治疗的十二指肠穿孔的自然病史。
The natural history of the perforated duodenal ulcer treated by suture plication.
作者信息
Griffin G E, Organ C H
出版信息
Ann Surg. 1976 Apr;183(4):382-5. doi: 10.1097/00000658-197604000-00009.
This retrospective study of 174 patients with proven duodenal ulcer perforation was undertaken to delineate the natural history of those patients primarily managed by suture plication. During this 25-year period, 122 patients (70%) were treated with suture plication and 52 (30%) underwent a definitive procedure. There were 13 deaths in the overall group (7.4%) of which the mortality was 6.5% in the plicated group and 9.6% in the definitive group. Of the 122 patients treated with suture plication, 48% either 1) died of ulcer complications later, 2) required reoperation for ulcer disease, or 3) were under active treatment for ulcer symptoms. The reperforation rate in the entire series was 9% and the reoperation rate 32%. Suture plication is a time-honored, life-saving procedure, however, definitive surgery is a superior form of long-term management of the perforated duodenal ulcer patient.
本回顾性研究纳入了174例确诊为十二指肠溃疡穿孔的患者，旨在描述那些主要采用缝合折叠术治疗的患者的自然病程。在这25年期间，122例患者（70%）接受了缝合折叠术治疗，52例（30%）接受了确定性手术。整个组中有13例死亡（7.4%），其中缝合折叠术组的死亡率为6.5%，确定性手术组为9.6%。在接受缝合折叠术治疗的122例患者中，48%的患者出现以下情况之一：1）后来死于溃疡并发症；2）因溃疡病需要再次手术；3）正在接受溃疡症状的积极治疗。整个系列中的再穿孔率为9%，再次手术率为32%。缝合折叠术是一种历史悠久、挽救生命的手术，然而，确定性手术是十二指肠溃疡穿孔患者长期治疗的更佳方式。
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