Ebrahem Rawaa, Kadhem Salam, Frey John W, Salyers William
Internal Medicine, University of Kansas School of Medicine-Wichita.
Kansas City University of Medicine and Biosciences.
Cureus. 2017 Apr 13;9(4):e1163. doi: 10.7759/cureus.1163.
Helicobacter pylori (H. pylori) infection is one of the major causes of bleeding peptic ulcer disease, which is associated with serious complications; therefore, the eradication of H. pylori is essential to prevent these devastating complications. Post-treatment follow-up is crucial to guarantee the eradication of the organism and may be conducted via the urea breath test, the stool antigen test, or a gastric biopsy. Acute massive upper gastrointestinal (UGI) bleeding is one of the most common complications of peptic ulcer disease. Aggressive treatment with early endoscopic hemostasis is essential for a favorable outcome. Recurrent massive nonvariceal UGI bleeding remains a challenge. Optimal management requires a multidisciplinary team of skilled endoscopists, intensivists, experienced UGI surgeons, and interventional radiologists. Endoscopy is the first-line treatment after hemodynamic stability is achieved. The role of early elective surgery or angiographic embolization in selected high-risk patients to prevent re-bleeding remains controversial.
幽门螺杆菌（H. pylori）感染是出血性消化性溃疡疾病的主要病因之一，该疾病会引发严重并发症；因此，根除幽门螺杆菌对于预防这些毁灭性并发症至关重要。治疗后的随访对于确保根除该病菌至关重要，可通过尿素呼气试验、粪便抗原检测或胃活检来进行。急性大量上消化道（UGI）出血是消化性溃疡疾病最常见的并发症之一。早期内镜止血的积极治疗对于取得良好疗效至关重要。复发性大量非静脉曲张性UGI出血仍然是一个挑战。最佳管理需要由技术熟练的内镜医师、重症监护医师、经验丰富的UGI外科医生和介入放射科医生组成的多学科团队。在内科患者血流动力学稳定后，内镜检查是一线治疗方法。早期选择性手术或血管造影栓塞在选定的高危患者中预防再出血的作用仍存在争议。
