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反流性食管炎合并胃肠道出血的治疗方法(作者译)

[Therapeutic procedures in hemorrhage into the gastro-intestinal tract in reflux-esophagitis (author's transl)].

作者信息

Duda M, Serý Z, Rocek V

出版信息

Langenbecks Arch Chir. 1982;356(1):1-6. doi: 10.1007/BF01270596.

Abstract

From 1976 and 1978, 158 patients with hematemesis and melaena from the upper gastro-intestinal tract were hospitalized at the Surgical clinic of the University Hospital in Olomouc. In 8.3%, reflux-esophagitis (ROe) and hiatal hernias (HH) were the cause of the hemorrhage. As a rule, the acute attack could be controlled by conservative treatment, and the operation was performed after the situation had calmed down. Only in exceptional cases an urgent operation was necessary. In the years from 1948 to 1979, 344 patients were operated on for reflux-esophagitis -- hemorrhage occurred only in 11.3%. In 32 patients the cause of the hemorrhage was a severe esophagitis and in 7 of them an esophageal ulcus. In reflux-esophagitis, hemorrhage is controlled by antireflex operations -- mostly by application of the fundoplicatio according to Nissen-Rossetti. When a duodenal ulcer or hyperacidity occur simultaneously, we combine fundoplicatio with superselective vagotomy.

摘要

1976年至1978年期间,158例上消化道出血伴呕血和黑便的患者入住奥洛穆茨大学医院外科诊所。其中8.3%的患者出血原因是反流性食管炎(ROe)和食管裂孔疝(HH)。通常情况下,急性发作可通过保守治疗得到控制,待病情稳定后再进行手术。仅在特殊情况下才需要紧急手术。1948年至1979年期间,344例患者因反流性食管炎接受手术,其中仅有11.3%发生出血。32例患者出血原因是严重食管炎,其中7例存在食管溃疡。对于反流性食管炎导致的出血,可通过抗反流手术控制,多数情况下采用尼森 - 罗塞蒂(Nissen-Rossetti)胃底折叠术。当同时存在十二指肠溃疡或胃酸过多时,我们会将胃底折叠术与超选择性迷走神经切断术联合应用。

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