Le Neel J C, Guiberteau B, Armstrong O, Borde L, Eloufir M, Burgos-Suarez B
Clinique Chirurgicale A, Hôtel-Dieu, Nantes.
Chirurgie. 1993;119(8):446-50; discussion 450-1.
Over a period of 7 years, 100 patients (70 males and 30 females; mean age 66 years) were operated for digestive tract haemorrhage originating in an ulcer. There was a past history of ulcer in 21% and 29% had been taking drugs known to have a toxic effect on the stomach. Patent bleeding was observed by endoscopy in 32% with clear arterial flow, or a visible vessel in 10. In 20 patients a fresh clot was observed. Surgery had been indicated for massive haemorrhage in 25 cases, for persistent bleeding in 27, for recurrent bleeding in 37 and due to a visible vessel in 11. Conservative treatment was possible in three-fourths of the cases. Gastrectomy was performed in 26. Follow-up was uneventful in 55. There were 18 cases with complications and 27 deaths factors leading to fatal outcome and the data reported in the literature were analyzed.
在7年的时间里，100例患者（70例男性和30例女性；平均年龄66岁）因溃疡引起的消化道出血接受了手术。21%的患者有溃疡病史，29%的患者一直在服用已知对胃有毒性作用的药物。32%的患者在内镜检查中观察到活动性出血，有明显的动脉血流，10%的患者可见血管。20例患者观察到新鲜血凝块。25例因大出血、27例因持续出血、37例因反复出血以及11例因可见血管而需要手术治疗。四分之三的病例可以进行保守治疗。26例行胃切除术。55例随访顺利。有18例出现并发症，27例死亡，分析了导致致命结局的因素以及文献报道的数据。
