国产吻合器在急诊胃大部切除手术中的应用(一)【摘要】目的探讨国产吻合器在急诊胃大部切除手术中的应用价值。方法对36例应用国产吻合器行胃大部切除术的胃十二指肠溃疡急性穿孔病例进行临床分析。其中十二指肠球部溃疡穿孔28例，胃窦部溃疡穿孔6例，胃小弯溃疡穿孔2例。采用BillrothⅠ式26例，BillrothⅡ式8例，Roux-en-y胃肠吻合2例。结果全组无吻合口瘘，无吻合口狭窄及出血。结论急诊情况下行胃大部切除术应用国产吻合器除具有出血少、手术时间短、胃肠功能恢复快、术后并发症少、可反复使用、价廉安全等优点外，还有使手术简单化的优点，值得临床推广应用。【关键词】吻合器；胃大部切除术；急诊手术ApplicationofhomemadestaplerinemergencyoperationofsubtotalgastrectomyYEHeng-jiang.DepartmentofSurgery，TheCentralHospitalofLishan,Suizhou441309，China〔Abstract〕ObjectiveToinvestigatetheapplicationvalueofhomemadestaplerinemergencyoperationofsubtotalgastrectomy.Methods36patientswithacuteperforationofgastroduodenalulcerweretreatedbysubtotalgastrectomyandhomemadestaplerwereused.Thecasenumbersoftheperforationsofduodenalbulbulcer，sinusventriculiandarcusminorventriculiulcerwere28，6and2，respectively.Amongthetotal，26caseswereoperatedbysubtotalgastrectomyofBillrothⅠ，8caseswereoperatedbyBillrothⅡand2caseswereoperatedbyRoux-en-ystomachintestineanastomose.ResultsAmongthetotal，nocasewasreportedwithstomafistula,stomastenosisandbleeding.ConclusionThereweremanyadvantagestoemergencyoperationofsubtotalgastrectomywithhomemadestapler，suchaslessbleeding，shortertimeofoperation，rapiderfunctionalrecoveryofstomachandintestine，lesscomplications，repeatableuse，lowercostandhighersafety，moreover，itmaketheoperationeasyandsimple.Itdeservestoextendtheutilizationofhomemadestaplerinmorehospitals.〔Keywords〕stapler;subtotalgastrectomy;emergencyoperation尽管目前药物治疗已使消化性溃疡治愈率得到很大提高，但近年来胃十二指肠溃疡穿孔的发生率却呈上升趋势。据文献报道：溃疡急性穿孔占消化性溃疡住院病例的10%～25%，在需要手术治疗的消化性溃疡患者中急性穿孔者约占21%，十二指肠溃疡（duodenalulcer，DU）穿孔多见，约占消化性溃疡急性穿孔的93.8%〔1〕...
