膈下游离气体为阴性的胃十二指肠穿孔28例诊治体会  

Diagnosis and Treatment of 28 Cases of Gastroduodenal Perforation Without Intraperitoneal Free Air in X-rays

作　　者：林李波[1] 徐小莉[1] 郭国湖[1] 何新卫[1] 邓兰树[1] 

机构地区：[1]汕头大学医学院第二附属医院,广东汕头515041

出　　处：《医学临床研究》2007年第5期736-737,共2页Journal of Clinical Research

摘　　要：【目的】探讨膈下游离气体为阴性的胃十二指肠穿孔的诊断与治疗。【方法】对2003-2006年收治的165例胃十二指肠穿孔，术前均行腹部X线透视或摄片。【结果】膈下游离气体阴性者28例，占17．0％（28／165）。术前明确诊断者21例，误诊为阑尾穿孔4例，诊断不明行剖腹探查3例。均行手术治疗，死亡1例。【结论】对于缺乏典型X线表现的胃十二指肠穿孔诊断有时较为困难，容易出现误诊、漏诊，须结合腹腔诊断性穿刺等其他手段。[Objective]To discuss the diagnosis and treatment of gastroduodenal perforation without intraperitoneal free air in x-rays. [Methods]The clinical data of 165 cases of gastroduodenal perforation in our hospital between 2003 and 2006 were analysed retrospectively. All cases were x-rayed the abdomen before opera- tion. [Results]Twenty eight cases were negative in x-ray of the abdomen, accounted for 17%. Of the 28 cases, 27 cases were cured and 1 case was dead after operation treatment. [Conclusion]For gastroduodenal perforation lack of typical x-ray presentation, it is necessary to combine diagnostic abdominal puncture with other examinations to avoid diagnostic errors and missed diagnosis. Sometimes, surgical exploration is needed.

关 键 词：胃溃疡/诊断 消化性溃疡穿孔/诊断 胃溃疡/治疗 消化性溃疡穿孔/治疗 

分 类 号：R656.62[医药卫生—外科学]