胃十二指肠溃疡大出血给予胃大部切除术治疗的临床分析

陈维

[摘要] 目的 分析胃大部切除术治疗胃十二指肠溃疡大出血的临床应用效果。方法 方便选取2017年10月—2018年10月期间该院收治的70例胃十二指肠溃疡大出血患者，按照盲选方法将所有研究对象随机分为2组，一组为对照组（n=35），采用止血药物进行保守治疗，另一组为研究组（n=35），采用胃大部切除术治疗，对比两种方法的治疗效果。结果对照组的临床治疗总有效率80.00%显著低于研究组97.14%，组间对比差异有统计学意义（χ2=5.080，P=0.020<0.05）。对照组的胃肠功能恢复时间及住院时间均明显长于研究组，其总出血量明显大于研究组，差异有统计学意义（t=19.229，54.587，15.203;P<0.01）。对照组的并发症发生率22.85%明显高于研究组5.71%，数据对比差异有统计学意义（χ2=4.200，P=0.040<0.05）。 结论 与保守方法治疗相比较，胃大部切除术治疗胃十二指肠溃疡大出血，有利于提高治疗效果，可显著改善患者的临床症状，更加安全有效，值得在临床大力推广和使用。

[关键词] 胃大部切除术;保守治疗;胃十二指肠溃疡大出血;疗效;并发症

[中图分类号] R656.6+2          [文献标识码] A          [文章编号] 1674-0742（2019）05（a）-0070-03

[Abstract] Objective To analyze the clinical effect of subtotal gastrectomy in the treatment of massive gastroduodenal ulcer hemorrhage. Methods Seventy patients with massive gastroduodenal ulcer hemorrhage admitted to our hospital from October 2017 to October 2018 were convenient selected and randomly divided into two groups according to the blind selection method. One group was the control group （n=35）. The other group was the study group （n=35）. The curative effect of the two methods was compared. Results The total effective rate was 80.00% in the control group， which was significantly lower than that in the study group （97.14%）. There was a significant difference between the two groups（χ2=5.080， P=0.020<0.05）. The recovery time and hospitalization time of gastrointestinal function in the control group were significantly longer than those in the study group， and the total amount of bleeding in the control group was significantly larger than that in the study group （t=19.229， 54.587， 15.203; P<0.01）. The incidence of complications in the control group was 22.85%， which was higher than that in the study group （5.71%）. There was a significant difference between the two groups（χ2=4.200， P=0.040<0.05）. Conclusion Compared with conservative treatment， subtotal gastrectomy for massive gastroduodenal ulcer hemorrhage is conducive to improving the therapeutic effect. It can significantly improve the clinical symptoms of patients， which is safer and more effective， and is worthy of promotion and use in clinical practice.

[Key words] Subtotal gastrectomy; Conservative treatment; Massive bleeding from gastroduodenal ulcer; Curative effect; Complications

胃十二指腸溃疡大出血是溃疡基底部血管受到侵害后发生破裂所引发的出血症状，患者在临床主要表现为大量呕血、便血等症状[1]。该病具有极高的危险性，严重威胁患者生命安全，因此临床积极治疗的关键在于早日进行止血，补充血容量[2]。外科手术及内科药物疗法均为临床治疗胃十二指肠溃疡出血的有效方法[3-4]。但目前临床在治疗方法的选择上仍然存在着较大的争议[5]。该组研究通过将该院2017年10月—2018年10月收治的70例胃十二指肠溃疡大出血患者随机分成2组，分别采用止血药物进行保守治疗和胃大部切除术治疗，观察两种治疗方法的应用效果，现报道如下。