陳維

[摘要] 目的 分析胃大部切除術(shù)治療胃十二指腸潰瘍大出血的臨床應(yīng)用效果。方法 方便選取2017年10月—2018年10月期間該院收治的70例胃十二指腸潰瘍大出血患者，按照盲選方法將所有研究對象隨機分為2組，一組為對照組（n=35），采用止血藥物進行保守治療，另一組為研究組（n=35），采用胃大部切除術(shù)治療，對比兩種方法的治療效果。結(jié)果對照組的臨床治療總有效率80.00%顯著低于研究組97.14%，組間對比差異有統(tǒng)計學(xué)意義（χ2=5.080，P=0.020<0.05）。對照組的胃腸功能恢復(fù)時間及住院時間均明顯長于研究組，其總出血量明顯大于研究組，差異有統(tǒng)計學(xué)意義（t=19.229，54.587，15.203;P<0.01）。對照組的并發(fā)癥發(fā)生率22.85%明顯高于研究組5.71%，數(shù)據(jù)對比差異有統(tǒng)計學(xué)意義（χ2=4.200，P=0.040<0.05）。 結(jié)論 與保守方法治療相比較，胃大部切除術(shù)治療胃十二指腸潰瘍大出血，有利于提高治療效果，可顯著改善患者的臨床癥狀，更加安全有效，值得在臨床大力推廣和使用。

[關(guān)鍵詞] 胃大部切除術(shù);保守治療;胃十二指腸潰瘍大出血;療效;并發(fā)癥

[中圖分類號] R656.6+2? ? ? ? ? [文獻標(biāo)識碼] A? ? ? ? ? [文章編號] 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

胃十二指腸潰瘍大出血是潰瘍基底部血管受到侵害后發(fā)生破裂所引發(fā)的出血癥狀，患者在臨床主要表現(xiàn)為大量嘔血、便血等癥狀[1]。該病具有極高的危險性，嚴重威脅患者生命安全，因此臨床積極治療的關(guān)鍵在于早日進行止血，補充血容量[2]。外科手術(shù)及內(nèi)科藥物療法均為臨床治療胃十二指腸潰瘍出血的有效方法[3-4]。但目前臨床在治療方法的選擇上仍然存在著較大的爭議[5]。該組研究通過將該院2017年10月—2018年10月收治的70例胃十二指腸潰瘍大出血患者隨機分成2組，分別采用止血藥物進行保守治療和胃大部切除術(shù)治療，觀察兩種治療方法的應(yīng)用效果，現(xiàn)報道如下。