Lundell Lars
Department of Surgery, Huddinge University Hospital, Stockholm, Sweden.
Dig Dis. 2003;21(1):16-8. doi: 10.1159/000071334.
During the last decades, significant advantages have been achieved with the use of emergency endoscopy and respective hemostatic interventions. Rebleeding, however, remains a significant clinical problem, and currently re-endoscopy or surgical intervention offers advantages and disadvantages. With the discovery of Helicobacter pylori as a main causative factor behind peptic ulcer disease, a more conservative surgical approach is mandated even in situations with significant rebleeding. In case of large gastric ulcer, however, resection is a wise strategy depending on the risk of malignancy. Liver transplantation has immensely improved the prognoses for variceal bleeding in end-stage liver disease in carefully selected patients.
在过去几十年中，紧急内镜检查及相应的止血干预措施已取得显著成效。然而，再出血仍是一个严重的临床问题，目前再次内镜检查或手术干预各有优缺点。随着幽门螺杆菌被发现是消化性溃疡疾病的主要致病因素，即使在严重再出血的情况下，也需要采取更为保守的手术方法。然而，对于大的胃溃疡，根据恶性肿瘤风险，切除是明智的策略。肝移植极大地改善了精心挑选的终末期肝病患者静脉曲张出血的预后。
