Bouillot J L, Chenebaux D, Bloch F, Gripon S, Loulidi S, Petite J P, Alexandre J H
Service de Chirurgie Générale et Digestive, Hôpital Broussais, Paris.
Ann Chir. 1991;45(10):877-81.
From January 1983 to December 1987, 127 patients with bleeding peptic ulcer were admitted to hospital. The mean age of the 85 males was 57 years and 72 years for 42 females. All but four of the patients were managed medically after emergency endoscopy. Twenty-seven patients required surgical operations (21.2%): seven for cataclysmic haemorrhage, eight for persistent haemorrhage, twelve for recurrent bleeding. An analysis of factors leading to the necessity of surgical haemostasis was undertaken by considering the clinical status, endoscopic findings and laboratory results. The size of the ulcer (greater than 2 cm) was the most significant parameter (less than 0.01). Five other criteria (rectal bleeding) shock, endoscopic signs of recent haemorrhage, gastric or duodenal posterior ulcer) were also significant (p less than 0.05). Considering the gravity of these patients (six deaths among twenty-seven), clinical trials in bleeding peptic ulcer disease should only include patients in the high risk group.
1983年1月至1987年12月，127例消化性溃疡出血患者入院治疗。85例男性患者的平均年龄为57岁，42例女性患者的平均年龄为72岁。除4例患者外，其余所有患者在急诊内镜检查后均接受药物治疗。27例患者需要进行外科手术（21.2%）：7例因灾难性出血，8例因持续性出血，12例因反复出血。通过考虑临床状况、内镜检查结果和实验室检查结果，对导致手术止血必要性的因素进行了分析。溃疡大小（大于2 cm）是最显著的参数（小于0.01）。其他五个标准（直肠出血、休克、近期出血的内镜征象、胃或十二指肠后壁溃疡）也具有显著性（p小于0.05）。考虑到这些患者的严重性（27例中有6例死亡），消化性溃疡出血疾病的临床试验应仅纳入高危组患者。
