Kŭnchev K N
Vutr Boles. 1984;23(5):21-9.
It is a follow up of 242 patients with gastric ulcer disease. Sixty two per cent of them were observed for more than 3 years. They were controlled by X-ray examinations (41%) or endoscopically (59%). Full recovery was obtained in 127 patients (53%). A total of 115 were not healed until the end of the survey. The risk of malignisation is estimated as very low. Only 5 patients developed cancer of the stomach (2,06%). Much more important is the early differential diagnosis between gastric ulcer and the primary ulcerative form of gastric cancer. The follow up care of a gastric ulcer disease should be effectuated not by X-ray but by gastrofibroscopic examinations in individual terms and aimed biopsies should be taken as much as possible. Operation is rejected as standard policy in gastric ulcers that were not healed after 3-month medical treatment. It seems advisable to avoid gastroduodenal resection (Billroth II) for gastric ulcer, as a remote prophylaxis against primary cancer of the gastric stump.
这是对242例胃溃疡患者的随访。其中62%的患者接受了超过3年的观察。他们通过X线检查(41%)或内镜检查(59%)进行监测。127例患者(53%)实现了完全康复。共有115例患者直至调查结束仍未愈合。癌变风险估计非常低。仅有5例患者发生胃癌(2.06%)。更为重要的是胃溃疡与原发性溃疡性胃癌之间的早期鉴别诊断。胃溃疡疾病的随访不应通过X线检查,而应根据个体情况进行纤维胃镜检查,并尽可能进行靶向活检。对于经过3个月药物治疗仍未愈合的胃溃疡,不建议将手术作为标准治疗方案。为预防残胃癌的远期发生,似乎应避免对胃溃疡进行胃十二指肠切除术(毕Ⅱ式)。