Evaluation of Ultrasound Guided Percutaneous Drainage for Acute Perforation of Gastroduodenal Ulcer in Elderly Patients . _CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Guohu , GONG Jiaqing , WANG Peihong , ZHANG Lin , CAO Yongkuan

The PLA Medical Center of General Surgery, General Hospital of Chengdu Military Area, Chengdu 610083， China;

Corresponding author：

Keywords：

Elderly patient; Acute perforation of gastroduodenal ulcer; Abdominal puncture drainage; Stomach Ulcer; Duodenal Ulcer

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Objective To evaluate the effect of ultrasound guided percutaneous drainage on acute perforation of gastroduodenal ulcer in elderly patients. Methods The clinical features, treatments, and the curative effects of 86 elderly cases (≥65 years) of acute perforation of gastroduodenal ulcer in our hospital between January 2004 and October 2009 were retrospectively analyzed. Twenty-one cases were treated by ultrasound guided percutaneous drainage (drainage group), and 65 cases were treated by exploring operation (operation group). Results Drainage group was cured and had no complications. In 15 patients which accepted recheck one month after drainage, gastroscope showed the ulcer healed in 12 cases， and improved in 3 cases.　In operation group, 63 cases were cured and 2 cases died. Compared with the drainage group, there was no significant difference in cure rate (P gt;0.05). However, 11 patients had operative complications in operation group, which was significantly more than that in the drainage group （P lt;0.05）. In 45 patients which accepted recheck one month after operation, gastroscope showed the ulcer healed in 38 cases， and improved in 7 cases. Conclusion For elderly patients with acute perforation of gastroduodenal ulcer， if the patients do not fit for exploring operation， ultrasound guided percutaneous drainage is proved to be a simple, safe, and effective means.

Citation： ZHANG Guohu,GONG Jiaqing,WANG Peihong,ZHANG Lin,CAO Yongkuan. Evaluation of Ultrasound Guided Percutaneous Drainage for Acute Perforation of Gastroduodenal Ulcer in Elderly Patients . . CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(11): 1186-1189. doi: Copy

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17.	韦光远. 老年人胃十二指肠溃疡急性穿孔121例的临床特点及治疗对策 [J]. 广西医学, 2009; 31(10): 1479-1480.
18.	向国安，陈开运，高鹏，等. 腹腔镜在急腹症中的应用 [J]. 中国微创外科杂志， 2005; 5(8): 651-652.
19.	Michelet I, Agresta F. Perforated peptic ulcer: laparoscopic approach [J]. Eur J Surg, 2000; 166(5): 405-408.
20.	李英俊, 孙玉兰, 孙元华, 等. 胃十二指肠溃疡穿孔治疗方式的探讨(附300例报告) [J]. 腹腔镜外科杂志, 2006; 11(6): 489-491.
21.	杨卫富, 印山河, 朱华生. 胃十二指肠溃疡急性穿孔急诊治疗策略 [J]. 中国微创外科杂志, 2009; 9(1): 21-23.
22.	陈训如. 普通外科微创技术应用现状及展望 [J]. 中国普外基础与临床杂志, 2005; 12(6): 533-536.
23.	吕金利, 郭树军, 李永研, 等. B超引导下经皮穿刺置管治疗腹腔残余感染 [J]. 第三军医大学学报, 2008; 30(1): 90.
24.	宋家琳, 章建全, 赵皓珺, 等. 非血管超声造影指导下穿刺引流上消化道瘘的初步尝试 [J]. 第二军医大学学报, 2010; 31(7): 753-755.

1. 秦新裕. 胃十二指肠溃疡流行病学的新趋势 [J]. 中国实用外科杂志， 1998; 18(1): 5-6.
2. Zittel TT, Jehle EC, Becker HD. Surgical management of peptic ulcer disease today-indication, technique and outcome [J]. Langenbecks Arch Surg, 2000; 385(2): 84-96.
3. 贾宝庆, 李荣. 急性上消化道穿孔的非手术治疗 [J]. 医学综述, 2008; 14(16): 2534-2535.
4. 孙春亮, 杜丽萍, 李伟华, 等. 急性上消化道穿孔的保守治疗 [J]. 实用医药杂志, 2005; 22(11): 984-985.
5. 陈孝平. 外科学 [M]. 北京: 人民卫生出版社， 2005: 559-560.
6. 洪维聪，王冲杰. 上消化道急性穿孔保守治疗的分析 [J]. 现代实用医学， 2007; 19(10): 795.
7. Hermansson M, Stal von Holstein C, Zilling T. Surgical approach and prognostic factors after peptic ulcer perforation [J]. Eur J Surg, 1999; 165(6): 566-572.
8. Siu WT, Leong HT, Law BK, et al. Laparoscopic repair for perforated peptic ulcer: a randomized controlled trial [J]. Ann Surg, 2002; 235(3): 313-319.
9. 张延龄. 胃十二指肠溃疡手术治疗的重新评估 [J]. 国外医学·外科学分册, 2001; 28(2): 86-88.
10. 陈道达，陶凯雄. 消化性溃疡外科治疗的手术方式 [J]. 中国普外基础与临床杂志, 2000; 7（3）： 172-173.
11. 伍晓汀. 消化性溃疡外科治疗的现状及展望 [J]. 中国普外基础与临床杂志, 2000; 7（3）： 133-134.
12. Christensen S, Riis A, Nrgaard M, et al. Short-term mortality after perforated or bleeding peptic ulcer among elderly patients: a population-based cohort study [J]. BMC Geriatr, 2007; 7: 8.
13. Lee FY, Leung KL, Lai BS, et al. Predicting mortality and morbidity of patients operated on for perforated peptic ulcers [J]. Arch Surg, 2001; 136(1): 90-94.
14. Ng EK, Lam YH, Sung JJ, et al. Eradication of Helicobacter pylori prevents recurrence of ulcer after simple closure of duodenal ulcer perforation: randomized controlled trial [J]. Ann Surg, 2000; 231(2): 153-158.
15. 魏晓妍, 秦越. 老年人消化性溃疡114 例临床分析 [J]. 锦州医学院学报, 2002; 23(4): 41-42.
16. 赵建国，蔡兵，吴鸣宇, 等. 老年上消化道穿孔的临床特点和外科治疗 [J]. 中国现代医学杂志, 2010; 20(1): 120-122.
17. 韦光远. 老年人胃十二指肠溃疡急性穿孔121例的临床特点及治疗对策 [J]. 广西医学, 2009; 31(10): 1479-1480.
18. 向国安，陈开运，高鹏，等. 腹腔镜在急腹症中的应用 [J]. 中国微创外科杂志， 2005; 5(8): 651-652.
19. Michelet I, Agresta F. Perforated peptic ulcer: laparoscopic approach [J]. Eur J Surg, 2000; 166(5): 405-408.
20. 李英俊, 孙玉兰, 孙元华, 等. 胃十二指肠溃疡穿孔治疗方式的探讨(附300例报告) [J]. 腹腔镜外科杂志, 2006; 11(6): 489-491.
21. 杨卫富, 印山河, 朱华生. 胃十二指肠溃疡急性穿孔急诊治疗策略 [J]. 中国微创外科杂志, 2009; 9(1): 21-23.
22. 陈训如. 普通外科微创技术应用现状及展望 [J]. 中国普外基础与临床杂志, 2005; 12(6): 533-536.
23. 吕金利, 郭树军, 李永研, 等. B超引导下经皮穿刺置管治疗腹腔残余感染 [J]. 第三军医大学学报, 2008; 30(1): 90.
24. 宋家琳, 章建全, 赵皓珺, 等. 非血管超声造影指导下穿刺引流上消化道瘘的初步尝试 [J]. 第二军医大学学报, 2010; 31(7): 753-755.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of Ultrasound Guided Percutaneous Drainage for Acute Perforation of Gastroduodenal Ulcer in Elderly Patients . 

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