Kharaberiush V A, Kondratenko P G, Sobol A A, Elin A F
Klin Khir (1962). 1994(8):18-22.
The results of treatment of 380 patients with the globular volume deficiency of 40% and more, operated in urgency for ulcer gastroduodenal bleeding. In 124 (32.6%) of them ulcer was localized in the stomach, in 224 (64.2%)--in pyloroduodenal region, in 12 (3.2%)--the combined ulcers were revealed. Cause of the death was an acute cardiovascular insufficiency in 11.1% of patients, thromboembolia of the pulmonary artery--in 1.3%, bleeding ulcer or erosion--in 1.6%. Suture insufficiency of the duodenal stump and anastomoses occurred in 5.8%, pneumonia--in 12.6%, purulent complications--in 6.3%. The conduction of proposed surgical tactics permitted to lower the mortality after operations for persistent bleeding down to 12.5%, the prevalence of recurrent bleeding occurrence--to 12.5%. The prevalence of operations accomplishment in the patients with high risk of bleeding recurrence have increased up to 78.7%, radical intervention--to 70.7%. The authors make a conclusion about perspectivity of the proposed elaborated an active-rational therapeutical tactics in the patients with severe gastroduodenal bleeding.
对380例球部容积缺损达40%及以上、因溃疡胃十二指肠出血而急诊手术的患者的治疗结果。其中124例（32.6%）溃疡位于胃，224例（64.2%）位于幽门十二指肠区域，12例（3.2%）为复合性溃疡。死亡原因是11.1%的患者出现急性心血管功能不全，1.3%的患者出现肺动脉血栓栓塞，1.6%的患者出现溃疡或糜烂出血。十二指肠残端和吻合口缝线不愈合发生率为5.8%，肺炎发生率为12.6%，化脓性并发症发生率为6.3%。采用建议的手术策略可使持续性出血手术后的死亡率降至12.5%，复发性出血发生率降至12.5%。出血复发高危患者手术完成率升至78.7%，根治性干预升至70.7%。作者得出结论，所提出的针对严重胃十二指肠出血患者的积极合理治疗策略具有前景。
