[溃疡型胃十二指肠出血的手术策略及死亡原因]

[Surgical tactics and causes of death in ulcer gastroduodenal bleedings].

作者信息

Repin V N, Kostylev L M, Vozgoment A O, Tkachenko I M, Kravtsova T Iu

出版信息

Khirurgiia (Mosk). 2010(3):27-30.

PMID:20517263

Abstract

4212 patients with ulcer gastrointestinal bleedings were treated during 1990-2007 years. 364 patients had gastric ulcers, other patients had duodenal ulcers. 1819 patients (43.2%) were operated. 418 patients (23%) were operated due to ineffective endoscopic hemostasis and recurrent bleedings. 409 patients (22.5%) underwent urgent operations because of risk for recurrent bleeding. Elective operations were carried out to 1358 patients (74.7%). Postoperative lethality amounted 5.8% including 19.1% lethality after emergency operations, 4.2% lethality - after urgent operations and 0.8% lethality - after delayed operations. The general hospital lethality amounted 3.3%. Lethality can be decreased by extension of indications for urgent operations, preventing recurrent bleedings.

摘要

1990年至2007年间，对4212例患有胃肠道溃疡出血的患者进行了治疗。其中364例患有胃溃疡，其余患者患有十二指肠溃疡。1819例患者（43.2%）接受了手术。418例患者（23%）因内镜止血无效和反复出血而接受手术。409例患者（22.5%）因有反复出血风险而接受急诊手术。1358例患者（74.7%）接受了择期手术。术后死亡率为5.8%，其中急诊手术后死亡率为19.1%，急诊手术后死亡率为4.2%，延期手术后死亡率为0.8%。综合医院死亡率为3.3%。通过扩大急诊手术适应症、预防反复出血，可以降低死亡率。