修补或加PCV后清除Hp治疗十二指肠溃疡穿孔的疗效观察  

Clinic evaluation of simple repair or plus PCV followed by removal of Hp in patients with perforated pyloroduodenal ulcer

作　　者：金正明[1] 石长青[1] 张新连[1] 宗兵[1] 

机构地区：[1]上海复旦大学医学院附属金山医院,上海200540

出　　处：《宁夏医学杂志》2001年第10期588-590,共3页Ningxia Medical Journal

摘　　要：目的　观察幽门十二指肠溃疡穿孔后单纯修补或加壁细胞迷切 (PCV)并常规清除幽门螺杆菌 (Hp)后的疗效。方法　收治幽门十二指肠溃疡穿孔 67例 ,其中单纯修补 4 1例 ,修补加PCV10例。以上二组 ,术后常规清除Hp。结果　经 1～ 6年的随访 ,单纯修补或加PCV术后再常规清除Hp ,溃疡复发率和再手术率都明显降低 ;修补加PCV组疗效明显优于单纯修补组 (P <0 0 5 ) ;单纯修补组中 ,急性溃疡穿孔病例的疗效明显优于慢性溃疡穿孔 (P <0 0 5 )。结论　 ( 1)单纯修补术后再清除Hp可作为急性溃疡穿孔的首选治疗方案 ;( 2 )Objectives To evaluate the therapeutic effect of simple repair or plus parietal cell vagotomy(PCV)followed by removal of Helicobacter pylori(Hp)in patients with perforated pyloroduodenal ulcer.Methods Since 1994,67 cases suffering from perfo rated pyloroduodunal ulcer had been treated in our hospital,among them 41 cases underwent simple repair,10 cases with repair plus PCV.All patients in two groups were treated by removal of Hp after operation.The clinic data were retrospectively alalyzed.Results The patients were followed up for 1～6 years.The result showed that the recurrent rate of ulcer and reoperative rate were decreased in two groups.The therapeutic effect of group of repair plus PCV was better than group of simple repair significantly( P <0 05).The therapeutic effect of acute ulute cases were better than chronic ulcer cases in the simple repair group obviously( P <0 05).Conclusion (1)Simple repair followed by removal of Hp should be as the firsh choice for the cases of perforated acute ulcer.(2)Repair plus PCV followed by removal of Hp could be acquired a good result.

关 键 词：十二指肠溃疡 穿孔 幽门螺杆菌 PCV术 修补术 

分 类 号：R656.62[医药卫生—外科学]