Borch K, Jansson L, Sjödahl R, Anderberg B
Department of Surgery, University Hospital, Linköping, Sweden.
Acta Chir Scand. 1988 Mar;154(3):211-4.
Etiological factors and prognosis were analyzed in 78 patients with haemorrhagic gastritis admitted to an intensive care unit during 8 years. These patients constituted 11.4% of a total of 684 cases with massive upper gastrointestinal haemorrhage admitted during the same time period. The annual incidence of haemorrhagic gastritis was 6.5/100,000 inhabitants. Most frequently, the bleeding episode was associated with intake of alcohol (35%) or anti-inflammatory drugs (23%). Only 4 patients (5%) had classical stress ulcers. Due to massive bleeding, surgery was necessary in 5 patients. Non-resectional surgery was carried out with no postoperative mortality. Six patients (8%) died (age 72-92 years), one as a direct cause of bleeding and five in severe associated disease, haemorrhagic gastritis being more or less a terminal event. Thus, in the great majority of unselected patients with haemorrhagic gastritis bleeding ceases on conservative treatment. In a minor fraction surgical treatment is a last resort but the method of choice is debatable. We propose that gastric resection should be avoided.
对8年间收入重症监护病房的78例出血性胃炎患者的病因和预后进行了分析。这些患者占同期收治的684例大量上消化道出血病例的11.4%。出血性胃炎的年发病率为6.5/10万居民。最常见的是，出血发作与饮酒（35%）或服用抗炎药（23%）有关。只有4例患者（5%）有典型的应激性溃疡。由于大出血，5例患者需要手术治疗。实施了非切除性手术，术后无死亡病例。6例患者（8%）死亡（年龄72 - 92岁），1例直接死于出血，5例死于严重的相关疾病，出血性胃炎或多或少是一种终末期事件。因此，在绝大多数未经选择的出血性胃炎患者中，保守治疗出血会停止。在少数情况下，手术治疗是最后的手段，但选择的方法存在争议。我们建议应避免胃切除术。
