An Investigation Of Diagnosis And Treatment For Peptic Ulcer Perforation In Hengyang City Based On Questionnaire Survey

Objectives: To explore the PPU diagnostic and treatment of general surgeons or gastrointestinal surgeons in Heng Yang city and to analyze the differences between secondary hospitals and tertiary hospitals in terms of the methods of diagnosis and treatment as well as the cognition towards PPU, in order to improve the condition of PPU diagnosis and treatment of the region.Methods: The cross-sectional survey method is adopted(see appendix). According to the questionnaires of gastrointestinal surgeons(general surgeons) in Heng Yang city, 118 surgeons were surveyed from 5 districts,7 counties. The survey contains the basic information of surgeons and the methods of diagnosis and treatment in patients who suffer from PPU. The author established Excel database and divided these samples into two groups according to the secondary hospital and tertiary hospital, using chi-square to compare the differences between the two groups, and evaluated them in the end.Results: There were 126 questionnaires in total, 118 of which were valid ones and were received for the study. Among the surveyed surgeons, 57 are from the secondary hospitals, while the other 61 are from the tertiary hospitals. Erecting abdominal X-ray and simple repairing with omentum are one of the most popular diagnostic methods and surgical operation used by surgeons, accounting for 78.81% and 84.75% respectively.We found that the surgeons from the tertiary hospitals use CT scan in the diagnosis of PPU more frequently than those in secondary hospitals. Surgeons from the secondary hospital prefer open surgery(63.16%) to minimally invasive surgery(33.33%). While in tertiary hospitals, 60.66% surgeons tend to use laparoscope operation. Except one surgeon who seldom installs preventive abdominal cavity drainage, all other surgeons believe it necessary to conduct anti-ulcer(namely by acid suppression and anti-helicobacter pylori treatment) after operation, together with intraoperative washing abdominal cavity in operation and abdominal cavity drainage placement. Secondary hospitals and tertiary hospitals share the main reference conditions for surgeons to conduct conservative treatment, including whether patients can tolerate surgery and anesthesia or not, whether their families agree with surgery,more than 24 hours acute abdominal pain and peritonitis limitation or not,and whether water-soluble contrast medium through duodenum has been confirmed to be closed or not, as well as an empty stomach at the time of perforation. More surgeons in tertiary hospitals consider the patients who with perforated more than 24 hours and peritonitis has been limited could be treated by non-surgical treatment.No differences were found between two groups in terms of the aspects mentioned above.Conclusion: 1. Significant differences exist in the composition of highest academic degree, diagnostic methods of PPU and whether peptic ulcer perforation was treated by laparoscope among the surgeons of the Department of Gastrointestinal Surgery or the Department of General Surgery in secondary and tertiary hospitals in Hengyang city. 2. No apparent differences are detected in main reference conditions, including gender, professional title, age, the time of specialized work, surgical design for treating peptic ulcer perforation, postoperative anti-ulcer treatment or not, intraoperative cleaning of abdominal cavity and placement of drainage or not, and nonoperative treatment, among the surgeons of the Department of Gastrointestinal Surgery or the Department of General Surgery in secondary and tertiary hospitals in Hengyang city.