Aliev S A, Khydyrova N M
Khirurgiia (Mosk). 2010(2):30-7.
Treatment results of 476 patients with acute gastroduodenal ulcer bleeding were analyzed. Men comprised 75% (n=357), women - 25% (n=119). All patients were divided in two groups. Treatment principles of patients of the first group (36.8%; n=175) were based on active conservative treatment. Surgery was performed in 70.3%, postoperative lethality comprised 12.2%, overall mortality was 9.7%. Second group consisted of 301 patients (63.2%). Individual based active surgical treatment was performed, including clinical and endoscopic evaluation of local hemostasis, prognostic criteria of bleeding recurrence, differential approach in time, extent and method of the applied surgery. Operative treatment was used in 81.1% of patients of the second group, postoperative lethality comprised 9.8%, overall mortality was 8.0%. Emergency operations were performed in 43.6% (n=160) of all patients, early elective surgery in 56.4% (n=207). Postoperative lethality comprised 10.6%, overall mortality rate was 8.6%. Therefore, individual based active surgical treatment proved to be preferable. Gastric resection showed to be more advisable then organ-preserving operations, considering emergency ulcer surgery.
对476例急性胃十二指肠溃疡出血患者的治疗结果进行了分析。男性占75%（n = 357），女性占25%（n = 119）。所有患者分为两组。第一组患者（36.8%；n = 175）的治疗原则基于积极的保守治疗。70.3%的患者接受了手术治疗，术后死亡率为12.2%，总死亡率为9.7%。第二组由301例患者组成（63.2%）。采用基于个体的积极手术治疗，包括对局部止血的临床和内镜评估、出血复发的预后标准、在时间、范围和应用手术方法上的差异处理。第二组81.1%的患者接受了手术治疗，术后死亡率为9.8%，总死亡率为8.0%。所有患者中43.6%（n = 160）进行了急诊手术，56.4%（n = 207）进行了早期择期手术。术后死亡率为10.6%，总死亡率为8.6%。因此，基于个体的积极手术治疗被证明是更可取的。考虑到急诊溃疡手术，胃切除术比保留器官的手术更可取。
