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[胃溃疡患者的药房观察与治疗]

[Dispensary observation and treatment of stomach ulcer patients].

作者信息

Bakalov V, Brailski Kh, Popov P

出版信息

Vutr Boles. 1979;18(1):26-33.

PMID:433248
Abstract

The results from the dispensary follow-up and prophylactic treatment of 175 patients with gastric ulcer in the course of 3 to 7 years (62% of the patients 5 from to 7 years) are reported. Two thirds of the patients are enlisted in the dispensary system during the first year after the disease onset. The ulcer disappears in 53.57 per cent by the end of the third month from the beginning of the treatment and in 81.43 per cent during the first 6 months. By the end of the first year, the ulcer was not closed in 8.57 per cent of the patients, hence 14.85 per cent of them underwent an operation. Control examinations and prophylactic treatment were conducted at least twice a year (in spring and autumn) in the course of three months. Recidivations occur rarely in the systematically treated patients, as well as hemorrhage and perforation of the ulcer as compared with the control group without a systematic prophylactic treatment. During the follow up, malignant degeneration of the ulcer was found in 9 patients (5.14%), 7 out of them were operated (5 at a relatively early period with a survival of 5 years in 60%). In more than the half of the patients with malignant degeneration, the duration of the gastric ulcer was over 6 years. Both the gigantic and the ulcers with small dimensions could have a malignant degeneration. Cancer degenerated ulcer are more frequently localized in the horizontal part of the lesser and greater stomach curvatures and subcardially. With a view to the timely diagnosis of cancer degeneration of the ulcer, the patients are advised to keep the control examinations under dispensary conditions--clinically, at the laboratory and endoscopically-biopsy at least two times a year.

摘要

报告了175例胃溃疡患者在3至7年(62%的患者为5至7年)期间进行药房随访和预防性治疗的结果。三分之二的患者在疾病发作后的第一年内进入药房系统。治疗开始后第三个月末,溃疡消失率为53.57%,前6个月内为81.43%。到第一年末,8.57%的患者溃疡未愈合,因此其中14.85%的患者接受了手术。在三个月的时间里,每年至少进行两次(春季和秋季)对照检查和预防性治疗。与未进行系统预防性治疗的对照组相比,接受系统治疗的患者很少复发,溃疡出血和穿孔的情况也较少。在随访期间,发现9例患者(5.14%)溃疡发生恶变,其中7例接受了手术(5例在相对早期进行手术,60%的患者存活5年)。在超过一半的恶变患者中,胃溃疡病程超过6年。巨大溃疡和小溃疡都可能发生恶变。癌变溃疡更常位于胃小弯和大弯的水平部以及贲门下方。为了及时诊断溃疡恶变,建议患者在药房条件下进行对照检查——临床、实验室和内镜活检至少每年两次。

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