目的总结胃大部切除术治疗消化性溃疡急性穿孔的临床经验,旨在提高该病Ⅰ期手术治愈的成功率。方法回顾性分析208例消化性溃疡急性穿孔的临床资料,其中86例(41.35%)采用胃大部连同病灶切除,Ⅰ期治愈;胃肠重建采用BillrothⅠ式吻合18例(20.93%),BillrothⅡ式吻合68例(79.07%),其中BillrothⅡ式结肠前吻合42例(61.76%),结肠后吻合26例(38.24%)。结果86例中,1例BillrothⅡ式吻合术后发生胃瘫,经保守治疗月余治愈,其余病例术后恢复均顺利,随访5年以上预后良好。结论消化性溃疡急性穿孔Ⅰ期行胃大部切除术治疗,既解决了穿孔单纯修补术后再次复发穿孔、出血、幽门梗阻、粘连、溃疡恶变等问题,又缩短了治愈周期,提高了生存质量。 Objective To summarize the clinical experience of subtotal gastrectomy in the treatment of acute perforation of peptic ulcer, aiming to improve the success rate of first-stage surgical cure of the disease. Methods A retrospective analysis of 208 cases of peptic ulcer acute perforation clinical data, of which 86 cases (41.35%) were treated with resection of the stomach and lesions, the first phase of cure; gastrointestinal reconstruction by Billroth Ⅰ anastomosis in 18 cases (20.93%), Billroth Ⅱ formula The anastomosis of 68 cases (79.07%), including Billroth Ⅱ colon anastomosis in 42 cases (61.76%), 26 cases after colon anastomosis (38.24%). Results Of the 86 cases, 1 case had gastroparesis after Billroth Ⅱ anastomosis. After more than a month of conservative treatment, the rest of the cases were successfully recovered. The prognosis was good after 5 years of follow-up. Conclusions Peptic ulcer acute perforation stage Ⅰ gastrectomy treatment not only solves the recurrence of perforation after simple repair of perforation, bleeding, pyloric obstruction, adhesions, ulcer malignant problems, but also shorten the cure cycle and improve the quality of life .