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[急性消化性溃疡所致胃肠道出血治疗的各种特殊问题]

[Various special problems of the treatment of acute peptic ulcer- induced gastrointestinal hemorrhage].

作者信息

Kurygin A A, Baranchuk V N

出版信息

Vestn Khir Im I I Grek. 1989 May;142(5):12-5.

PMID:2800200
Abstract

The work has analyzed an experience with the treatment of 1336 patients with acute gastrointestinal bleedings of ulcerous etiology, 799 of them were operated upon. All the surgical interventions were divided into 3 categories: emergency operations (immediately after admission of the patient), delayed (within 24 hs) and planned operations (3 weeks later). Operative lethality was 5.2%, 11% and 1.8% correspondingly. Heavy blood loss was most frequent in gastric ulcer (37%) and retrobulbar ulcer of the duodenum (30%), less frequent in ulcer of the duodenum bulb (6.7%) and prepyloric ulcer (4.4%). Urgent fibrogastroscopy was used not only as a diagnostic method, but also as an attempt to control bleeding. Truncular vagotomy with draining operations are thought to be preferable for duodenal ulcers, for gastric ulcer--it is resection of the organ.

摘要

该研究分析了1336例溃疡性病因导致的急性胃肠道出血患者的治疗经验,其中799例接受了手术治疗。所有手术干预分为3类:急诊手术(患者入院后立即进行)、延迟手术(24小时内)和择期手术(3周后)。手术死亡率分别为5.2%、11%和1.8%。严重失血在胃溃疡(37%)和十二指肠球后溃疡(30%)中最为常见,在十二指肠球部溃疡(6.7%)和幽门管溃疡(4.4%)中较少见。紧急纤维胃镜检查不仅用作诊断方法,还用于尝试控制出血。对于十二指肠溃疡,认为迷走神经干切断术加引流手术更可取,对于胃溃疡,则是切除器官。

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