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目的总结胃、十二指肠溃疡急性穿孔的临床特点与治疗。方法回顾性分析74例胃十二指肠急性穿孔患者的临床资料。结果保守治疗15例,其中治愈14例,放弃治疗1例。手术治疗59例,其中治愈58例,死亡1例;手术并发症4例。结论胃、十二指肠溃疡急性穿孔是一种严重并发症,服用皮质醇类激素、非甾体类消炎药是其常见诱因。近年老年患者比例显著增高,多数患者具备典型临床表现,X线有重要诊断价值。要根据病情选择合理治疗方案,加强围术期处理可降低手术风险。
Objective To summarize the clinical characteristics and treatment of acute perforation of stomach and duodenal ulcer. Methods The clinical data of 74 patients with acute gastroduodenal perforation were retrospectively analyzed. Results of conservative treatment in 15 cases, of which 14 cases were cured, giving up treatment in 1 case. Surgical treatment of 59 cases, of which 58 cases were cured, 1 died; surgical complications in 4 cases. Conclusions The acute perforation of stomach and duodenal ulcer is a serious complication. Cortisol hormone and nonsteroidal anti-inflammatory drugs are the common causes. In recent years, the proportion of elderly patients increased significantly, the majority of patients with typical clinical manifestations, X-ray has important diagnostic value. According to the disease to choose a reasonable treatment options, strengthen the perioperative treatment can reduce the surgical risk.