Veligotskiĭ N N, Zaĭtsev V T, Derman A I, Boĭko V A
Khirurgiia (Mosk). 1989 Aug(8):88-91.
The current possibilities for identifying the sources and volumes of bleeding as well as the methods of local and general hemostatic therapy allow individual-active surgical tactics to be employed in acute hemorrhage from an ulcer. It is based on consideration for the severity, volume, rate, and duration of bleeding, the localization and visual appraisal of the ulcerous substrate and the vessel undergoing erosion, the patient's age, the concomitant pathological conditions, and the degree of the operative risk. Operations in such cases should be distributed into 3 groups: emergency, postponed, and early planned. Individual choice with due account for the indications for each group of operations, which was determined in 1,789 operative interventions, made it possible to reduce the total postoperative mortality to 2.9%.
目前,识别出血源和出血量的可能性以及局部和全身止血治疗方法,使得在溃疡急性出血时能够采用个体化的积极手术策略。这一策略基于对出血的严重程度、出血量、出血速度和持续时间、溃疡基底及受侵蚀血管的定位和视觉评估、患者年龄、伴随的病理状况以及手术风险程度的考虑。此类手术应分为三组:急诊手术、延期手术和早期计划性手术。在1789例手术干预中确定了每组手术的适应证,并进行个体化选择,从而有可能将术后总死亡率降至2.9%。