Paimela H, Kivilaakso E, Tuompo P, Peräkylä T, Höckerstedt K, Saarlo I
II Kirurgiska kliniken, HUCS, Helsingfors.
Nord Med. 1991;106(6-7):198-201.
To determine the effect of modern drug treatment on the incidence and type of ulcer operations, a retrospective survey was made of ulcer surgery performed on adult Helsinki residents during the years 1972, 1977, 1982 and 1987, with regard to indications and types of surgery. The introduction of H2-receptor blockers in 1979 was followed by a marked reduction in the incidence of elective ulcer surgery. On a population basis, the annual incidence of duodenal ulcer (DU) operations diminished by 50 per cent over the period 1972-1987, and that of operations for gastric ulcer by about two thirds, the falling trend being most marked among male DU patients. Figures for emergency surgical intervention in cases of haemorrhage or perforation remained unchanged during the period, as did the mean age of patients admitted for elective surgery, though the mean age of patients undergoing emergency surgery manifested a rising trend. The number of patients undergoing elective surgery for DU diminished, a trend first and foremost attributable to the fact that proximal selective vagotomy was performed more rarely, while the number of resections increased. The incidence of surgical treatment of pyloric and gastric ulcers remained unchanged during the period.
为了确定现代药物治疗对溃疡手术发生率和类型的影响,我们对1972年、1977年、1982年和1987年期间在赫尔辛基对成年居民实施的溃疡手术进行了回顾性调查,内容涉及手术指征和类型。1979年引入H2受体阻滞剂后,择期溃疡手术的发生率显著降低。以总体人群计算,1972 - 1987年期间十二指肠溃疡(DU)手术的年发生率下降了50%,胃溃疡手术的发生率下降了约三分之二,下降趋势在男性DU患者中最为明显。在此期间,出血或穿孔病例的急诊手术干预数字保持不变,择期手术患者的平均年龄也未改变,不过接受急诊手术患者的平均年龄呈上升趋势。接受DU择期手术的患者数量减少,这一趋势首先且主要归因于近端选择性迷走神经切断术的实施更为少见,而切除术的数量增加。在此期间,幽门和胃溃疡的手术治疗发生率保持不变。