Kharaberiush V A, Kondratenko P G, Ialovetskiĭ V D
Klin Med (Mosk). 1992 Nov-Dec;70(11-12):43-5.
The paper presented the results of surgical treatment of 277 patients with bleeding penetrating gastroduodenal ulcers. Gastric location of the ulcer was revealed in 52 patients and duodenal location in 225 ones. More commonly used resections of the stomach according to a Billroth-I method or suprapyloric resections versus the resection of the stomach according to method Billroth-II when used in the patients with gastric location of the ulcers helped to reduce the mortality from 23.1 to 0%. The wide usage of organ-sparing operations combined with vagotomy reduced the lethal outcomes of the disease from 13 to 5.5% versus the resection of the stomach. The rate of bleeding relapses in the early postoperative period which followed the suture of penetrating gastroduodenal ulcers was 25.9%. The dissection of ulcers or their elimination from the alimentary tract could be regarded as the methods of choice in case of palliative treatment. Surgical treatment of penetrating gastroduodenal ulcers should be performed prior to bleedings. Planned operative intervention should be performed in patients with deep gastric ulcer with diameter of 1.5 cm and more and pyloroduodenal ulcers with diameter of more than 1 cm.
该论文展示了277例穿透性胃十二指肠溃疡出血患者的手术治疗结果。其中52例溃疡位于胃，225例位于十二指肠。对于溃疡位于胃的患者，采用比罗特I式胃切除术或幽门上切除术比使用比罗特II式胃切除术更有助于将死亡率从23.1%降至0%。与胃切除术相比，广泛使用保留器官手术联合迷走神经切断术可将该疾病的致死率从13%降至5.5%。穿透性胃十二指肠溃疡缝合术后早期出血复发率为25.9%。在姑息治疗中，溃疡剥离或从消化道清除可被视为首选方法。穿透性胃十二指肠溃疡的手术治疗应在出血前进行。对于直径1.5厘米及以上的深部胃溃疡和直径超过1厘米的幽门十二指肠溃疡患者，应进行计划性手术干预。
