Indications And Effects Of Conservative Treatment For Fasting Peptic Ulcer Perforation

Objective:To explore the indications for conservative treatment of fasting peptic ulcer perforation and evaluate its efficacy.Methods:A retrospective analysis of the clinical data of 104 patients with fasting peptic ulcer perforation admitted to the First Affiliated Hospital of Nanchang University in the emergency department from January 2015 to December 2020,including: gender,age,onset season,ulcer history,comorbidities,Onset time,body temperature,heart rate,abdominal pain area,tenderness site,laboratory tests(WBC,NEUT,Hb,Alb,ALT,AST,TB,Cr,BUN),imaging tests(gas,fluid),cure rate,Complication rates,length of stay and treatment costs,etc.,were divided into conservative group and surgical group according to the treatment method finally selected after admission,and the relevant data between the two groups were statistically analyzed.Results:1.General information The age of the surgical group was 51(35.5-74)years old than the conservative group’s 45(23-62)years old,the difference was statistically significant(P<0.05);others include gender,onset season,history of ulcers,comorbidities,and time of onset Waiting is meaningless between the two groups(P>0.05).2.Physical examination The heart rate of 98(79.5-116.5)beats/min in the operation group was faster than 86(76-98)beats/min in the conservative group,and the difference was statistically significant(P<0.05);the rate of palpation of the whole abdominal tenderness in the operation group was also higher than that in the conservative group The difference between the two groups was also statistically significant(P<0.05);while the body temperature and abdominal pain area were not significant between the two groups(P>0.05).3.Auxiliary examination The Cr level of 84.2(66.1-139.7)umol/L in the operation group was higher than 71.4(59.1-83.4)umol/L in the conservative group,the difference was statistically significant(P<0.05);other laboratory indicators such as WBC,NEUT,Hb,Alb,ALT,AST,TB,BUN,etc.were not statistically significant between the two groups(P>0.05).CT imaging examination showed that free gas and abdominal and pelvic effusion were not statistically significant between the two groups(P>0.05).4.Treatment result The cure rate of conservative treatment was 96.2%,the complication rate of the conservative group was lower than that of the surgery group(P<0.05),the hospital stay in the conservative group was shorter than that of the surgery group(P<0.05),and the treatment cost was less than that of the surgery group(P<0.05).Conclusion:1.Age,heart rate,creatinine and tenderness are the risk factors for conservative treatment of fasting peptic ulcer perforation.2.Conservative treatment has fewer complications,shorter hospital stays,and lower treatment costs.For young patients with normal heart rate,normal creatinine,and mild peritonitis,conservative treatment can be the preferred treatment for some fasting peptic ulcer perforation patients.