MacDonald A S, Pyne D A, Freeman A N, Holland S G, Badley B W
Can J Surg. 1978 Jan;21(1):81-4.
Bleeding from hemorrhagic erosions in the stomach or duodenum of seriously ill patients is associated with a high mortality. While the pathogenesis of such lesions is by no means certain, it is known that they are universal after shock, sepsis or severe burns. Fiberoptic endoscopy has become the most valuable means of diagnosis. This should be preceded by gastric irrigaiton, which usually sufficies to control bleeding caused by acetylsalicylic acid or alcohol, or both. Neutralization of gastric acidity is essential. The histamine HI-receptor antagonist, cimetidine, was used in 27 patients with erosive gastritis, and bleeding ceased in 24. There is a prospect that sugh agents will obviate the necessity of total gastrectomy in the occasional resistant cases in favour of conservative surgery.
重症患者胃或十二指肠出血性糜烂引起的出血与高死亡率相关。虽然此类病变的发病机制尚不确定，但已知在休克、脓毒症或严重烧伤后普遍会出现。纤维内镜检查已成为最有价值的诊断手段。在此之前应进行洗胃，这通常足以控制由乙酰水杨酸或酒精或两者引起的出血。中和胃酸至关重要。组胺H1受体拮抗剂西咪替丁用于27例糜烂性胃炎患者，24例出血停止。有望在偶尔出现的耐药病例中，此类药物将避免全胃切除术的必要性，而倾向于保守手术。
