Rohner H G, Blömer A, Echterhoff H M, Gugler R
Z Gastroenterol. 1983 Oct;21(10):585-92.
To determine whether H2-antagonists have changed type and frequency of operations for peptic ulcer, all operations of the one hospital of a city with a population of 80 000 were analysed. The total number of operated patients decreased after cimetidine from 425 to 278 (35%). The ratio of male to female patients was 3:1 in either period. While the decrease in elective operations of uncomplicated ulcer was 51%, operations in patients with ulcer complications (bleeding, perforation, stenosis) decreased by only 9%. The decrease was above average in Billroth I and Billroth II gastrectomy, but the number of patients with selective vagotomy increased 3-fold. The number of operations decreased by 40% for duodenal ulcer and by 20% for gastric ulcer. Of all ulcer complications bleeding decreased by 31%, the number of perforations was unchanged, but the number of patients with stenosis increased by 58%. Overall mortality decreased from 25 in the initial to 20 in the subsequent five year period. Twenty and 19 patients, respectively, died with complicated ulcer disease (12,5% of all operations), mortality was 6 (1,5%) with operations for uncomplicated ulcer.
为确定H2拮抗剂是否改变了消化性溃疡的手术类型和频率，对一座拥有8万人口城市的一家医院的所有手术进行了分析。使用西咪替丁后，手术患者总数从425例降至278例（下降35%）。两个时期的男女患者比例均为3:1。单纯性溃疡择期手术减少了51%，而溃疡并发症（出血、穿孔、狭窄）患者的手术仅减少了9%。毕罗Ⅰ式和毕罗Ⅱ式胃切除术的减少幅度高于平均水平，但选择性迷走神经切断术的患者数量增加了3倍。十二指肠溃疡手术数量减少了40%，胃溃疡手术数量减少了20%。在所有溃疡并发症中，出血减少了31%，穿孔数量未变，但狭窄患者数量增加了58%。总体死亡率从最初的25例降至随后五年期的20例。分别有20例和19例患者死于复杂性溃疡病（占所有手术的12.5%），单纯性溃疡手术的死亡率为6例（1.5%）。
