Rösch W
Leber Magen Darm. 1985 Sep;15(5):198-204.
85% of all gastrointestinal bleeding occurs in the upper gastrointestinal tract. For this reason prophylactic and therapeutic efforts concentrate on the esophagus, stomach and duodenum. Prophylaxis of stress ulcers with H2-blockers and, in some specially endangered patients, with a combination treatment is well accepted. In regard to therapy of bleeding complications, however, medical and surgical treatment procedures compete. Stopping the bleeding during diagnostic endoscopy has gained considerable importance. Success depends - just as does success of pharmacotherapy - upon intensity of bleeding and morphology of the bleeding source (Forrest criteria). For prophylaxis of bleeding relapses from peptic lesions H2-blockers in combination with antacids or pirenzepine are treatment of choice.
所有胃肠道出血中85%发生在上消化道。因此，预防和治疗措施主要集中在食管、胃和十二指肠。使用H2受体阻滞剂预防应激性溃疡，对于一些特别高危的患者，则采用联合治疗，这一方法已被广泛接受。然而，在出血并发症的治疗方面，药物治疗和手术治疗方法存在竞争。在诊断性内镜检查期间止血已变得相当重要。其成功率——与药物治疗的成功率一样——取决于出血的严重程度和出血源的形态（福里斯特标准）。对于预防消化性病变出血复发，H2受体阻滞剂联合抗酸剂或哌仑西平是首选治疗方法。
