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目的 :通过分析 59例 6 0岁以上经手术和病理证实的胃十二指肠溃疡急性穿孔患者 ,总结老年人胃十二指肠溃疡急性穿孔的临床特点及治疗方法。结果 :胃溃疡穿孔 2 2例 ,十二指肠球部溃疡穿孔 37例。术前有并存病 30例 (50 .8% )。均行手术治疗 ,其中修补术 2 4例 ;胃大部分切除术 35例。治愈 52例 (88.1% ) ,死亡 7例 (11.9% ) ,术后并发症 2 5例 (4 2 .4 % )。结论 :老年人胃十二指肠溃疡急性穿孔患者具有临床症状与体征不典型 ,就诊时间偏晚 ,体温、白细胞计数变化不明显 ,并存病及并发症多等特点。
OBJECTIVE: To summarize the clinical features and treatment of acute perforation of gastroduodenal ulcer in the elderly with 59 cases of acute perforation of gastroduodenal ulcer confirmed by surgery and pathology. Results: There were 22 cases of gastric ulcer perforation and 37 cases of duodenal ulcer perforation. Preoperative coexisting disease in 30 cases (50.8%). All patients underwent surgical repair, of which 24 cases were repaired; 35 cases underwent partial resection of the stomach. 52 cases were cured (88.1%), 7 died (11.9%) and 25 cases (42.4%) were postoperative complications. Conclusion: The patients with acute perforation of gastroduodenal ulcer in the elderly are characterized by clinical symptoms and signs, late treatment, body temperature, insignificant changes in white blood cell count, coexisting diseases and complications.