Radovanović D, Stojanović D, Kalaba J
Klinika za hirurgiju, Klinicko bolnicki centar Dr Dragisa Misović, Beograd.
Med Pregl. 1995;48(5-6):178-81.
We have observed 428 patients with hemorrhages of the upper gastrointestinal tract; 7% of patients with stress lesions of the gastroduodenal mucosa being the cause of hemorrhages (4.9% were erosional stress hemorrhages and 2.1% were stress ulcera). Surgery is the most common cause of stress hemorrhages of the stomach and duodenum. They occur during the first 5 days after the surgery, whereas 70.59% (n = 12) occur during the first 72 hours. The localization of erosional hemorrhages of the stomach mucosa is mostly diffuse and that is why they are numerous (78.6% of the third degree) and hemorrhages are mostly heavy (the case with stress hemorrhages). Chronic peptic ulcera, especially duodenal (62.5% duodenal ulcera and 37.5% stomach ulcera) present an expressed risk factor for the occurrence of hemorrhagic erosions under the influence of the stress factor. The most common localization of the stress hemorrhagic ulcus is duodenum (66.7%) which is a potential danger for occurrence of the heaviest arterial hemorrhages. After major surgeries and during postoperative periods patients must be preventively protected by "antiulcus therapy" (especially patients with ulcera).
我们观察了428例上消化道出血患者;胃十二指肠黏膜应激性病变导致出血的患者占7%(其中4.9%为糜烂性应激性出血,2.1%为应激性溃疡)。手术是胃和十二指肠应激性出血最常见的原因。这些出血发生在手术后的前5天,其中70.59%(n = 12)发生在最初的72小时内。胃黏膜糜烂性出血的部位大多是弥漫性的,这就是为什么此类出血数量众多(三度出血占78.6%)且大多出血量大(应激性出血的情况)。慢性消化性溃疡,尤其是十二指肠溃疡(十二指肠溃疡占62.5%,胃溃疡占37.5%)是在应激因素影响下发生出血性糜烂的一个显著危险因素。应激性出血性溃疡最常见的部位是十二指肠(66.7%),这对发生最严重的动脉出血具有潜在危险。在大手术后及术后期间,患者必须接受预防性的“抗溃疡治疗”(尤其是溃疡患者)。