PDF(Pubmed)
Abstract：
(1) Background: Gastroduodenal perforation (GDP) is a life-threatening condition caused by a spontaneous or traumatic event. Treatment should be based on the mechanism of damage, timing, location, extent of the injury, and the patient\'s clinical condition. We aimed to examine several etiologic factors associated with gastroduodenal perforation and to search for the best method(s) for its prevention and treatment. (2) Methods: We conducted extensive literature reviews by searching numerous studies obtained from PubMed, Science Direct, and Cochrane for the following keywords: gastroduodenal perforation, Helicobacter pylori, NSAIDs\' use, side effects of GDP, laparoscopy, and surgery. The primary outcome was the reported occurrence of GDP. (3) Results: Using keywords, 883 articles were identified. After applying the inclusion and exclusion criteria, 53 studies were eligible for the current analyses, with a total number of 34,692 gastroduodenal perforation cases. Even though the risk factors of gastroduodenal perforation are various, the prevalence of H. pylori among patients with perforation is considerably high. As technology develops, the treatment for gastric perforation will also improve, with laparoscopic surgery having a lower mortality and complication rate compared to open surgery for GDP treatment. (4) Conclusions: H. pylori infection plays the most significant role in GDP, more than NSAIDs, surgery, chemotherapy, or transplantation. Treatment of H. pylori infection is essential to decrease the prevalence of GDP and speed up its recovery. However, urgent cases require immediate intervention, such as laparoscopic or open surgery.
摘要：
（1）背景：胃十二指肠穿孔（GDP）是由自发性或创伤性事件引起的危及生命的疾病。治疗应基于损伤的机制，定时,location,伤害的程度,以及患者的临床状况。我们旨在研究与胃十二指肠穿孔相关的几种病因，并寻找预防和治疗的最佳方法。(2)方法：我们通过搜索PubMed获得的大量研究进行了广泛的文献综述，科学直接，和Cochrane的以下关键词：胃十二指肠穿孔，幽门螺杆菌,NSAIDs\'使用,GDP的副作用，腹腔镜检查,和手术。主要结果是报告的GDP发生。（3）结果：使用关键词，共识别883篇文章。在应用纳入和排除标准后，53项研究符合当前分析的条件，共有34,692例胃十二指肠穿孔病例。尽管胃十二指肠穿孔的危险因素是多方面的,穿孔患者中幽门螺杆菌的患病率相当高.随着技术的发展,胃穿孔的治疗也会改善，与开腹手术相比，腹腔镜手术的死亡率和并发症发生率更低。(4)结论:幽门螺杆菌感染在GDP中的作用最为显著。超过NSAIDs,手术,化疗,或移植。幽门螺杆菌感染的治疗对于降低GDP的患病率和加快其恢复至关重要。然而,紧急情况需要立即干预，如腹腔镜或开腹手术。
