Shirinov Z T, Kurbanov F S, Domrachev S A, Bogopol'skiĭ P M
Khirurgiia (Mosk). 2005(4):28-30.
Two hundred and two patients with ulcers of a proximal part of the stomach (17.5% of all patients with gastric ulcer) were treated. In 135 (64.9%) patients these ulcers were complicated: in 28 (20.7%) -- malignant ulcers, in 42 (31.1%) -- bleeding ulcers, in 53 (39.3%) -- penetrating ones. Surgery was performed in 142 (70.3%) patients. A high rate of complications dictates a need to reduce period of conservative treatment of such ulcers to 6 months -- 1 year. Distal and proximal resection of the stomach are main surgeries in elective surgical treatment of patients with benign ulcers of cardia and sub-cardia. In malignant transformation gastrectomy is the most preferable. Suturing is indicated in perforated and bleeding ulcers, and if it is impossible -- distal subtotal resection of the stomach.
对202例胃近端溃疡患者(占所有胃溃疡患者的17.5%)进行了治疗。其中135例(64.9%)患者的溃疡出现了并发症:28例(20.7%)为恶性溃疡,42例(31.1%)为出血性溃疡,53例(39.3%)为穿透性溃疡。142例(70.3%)患者接受了手术治疗。高并发症发生率表明需要将此类溃疡的保守治疗时间缩短至6个月至1年。胃远端和近端切除术是贲门和贲门下方良性溃疡患者择期手术治疗的主要术式。发生恶性转化时,胃切除术是最可取的。对于穿孔性和出血性溃疡,若无法进行缝合,则应进行胃远端次全切除术。