Fusamoto H, Hagiwara H, Meren H, Kasahara A, Hayashi N, Kawano S, Sugimoto T, Kamada T
First Department of Medicine, Osaka University Medical School, Japan.
Am J Gastroenterol. 1991 Apr;86(4):429-33.
Gastrointestinal hemorrhage from stress ulceration is a life-threatening complication in a critically ill patient. We retrospectively studied 471 patients admitted to the Department of Traumatology of our hospital who developed shock in their clinical course. Forty-two patients (8.9%) developed gastrointestinal hemorrhage, most within 1 wk (76.2%). The hemorrhage lesion usually was located in the corpus of the stomach. The mortality rate of the shock patients with gastrointestinal hemorrhage was 33.3% (14 of 42). Comparison of different types of shock showed that the incidence, severity, and mortality rates of gastrointestinal hemorrhage were significantly higher in septic shock patients than in hemorrhagic shock patients. These findings show the importance of preventive therapy against progression of early mucosal damage and development of gastrointestinal hemorrhage in shock patients, especially those with sepsis.
应激性溃疡引起的胃肠道出血是危重症患者的一种危及生命的并发症。我们回顾性研究了我院创伤科收治的471例在临床过程中发生休克的患者。42例患者（8.9%）发生了胃肠道出血，大多数在1周内（76.2%）。出血病变通常位于胃体部。发生胃肠道出血的休克患者死亡率为33.3%（42例中的14例）。不同类型休克的比较显示，感染性休克患者胃肠道出血的发生率、严重程度和死亡率显著高于失血性休克患者。这些发现表明了预防休克患者尤其是脓毒症患者早期黏膜损伤进展和胃肠道出血发生的预防性治疗的重要性。
