Baer U, Diermann J, Erbe C
Chirurgische Abteilung, Städtischen Wenckebach-Krankenhauses Berlin-Tempelhof.
Zentralbl Chir. 1993;118(1):30-5.
94 patients have been operated upon for haemorrhagic gastroduodenal ulcer disease in the Wenckebach-Krankenhaus during the years 1986-1990. In all but 6 patients the ulcer has been controlled by an emergency gastroscopy. 25 of these patients had to undergo emergency operation at once for persistent bleeding after gastroscopy. From the other patients, another 31 suffered rebleeding and had to be laparotomised in an emergency procedure, too. Only in 38 cases an interval-operation was possible. No one of these 38 patients died. The overall mortality-rate was 14.9% (14 patients). The mean age of our patients was 68 (26-90) years, none of the patients under 60 years died, whereas the mortality-rate of the elder was as high as 20%. The operative procedures were ulcer excision and suturing of the bleeding vessel and distal gastrectomy. There was no difference in mortality-rates between resective and non resective procedures. Our aim to operate upon the patients in an elective way could be achieved in about one third only. Many patients refused an operation after primary control of bleeding.
1986年至1990年期间，温克巴赫医院对94例出血性胃十二指肠溃疡病患者进行了手术。除6例患者外，所有患者的溃疡均通过急诊胃镜得到控制。其中25例患者在胃镜检查后因持续出血不得不立即接受急诊手术。在其他患者中，另有31例再次出血，也不得不接受急诊剖腹手术。只有38例患者能够进行择期手术。这38例患者中无一死亡。总死亡率为14.9%（14例患者）。我们患者的平均年龄为68岁（26 - 90岁），60岁以下的患者无一死亡，而老年患者的死亡率高达20%。手术方式为溃疡切除、出血血管缝合和远端胃切除术。切除性手术和非切除性手术的死亡率没有差异。我们以择期方式对患者进行手术的目标仅在约三分之一的患者中得以实现。许多患者在出血初步得到控制后拒绝手术。
