Jatzko G, Lisborg P, Müller M, Wette V, Oschmautz H
Chirurgische Abteilung, Krankenhauses der Barmherzigen Brüder, St. Veit/Glan.
Wien Klin Wochenschr. 1993;105(9):255-8.
The surgical procedure in acute complications of gastroduodenal ulcers is examined with regard to risk factors and mortality. Emergency admissions to an Austrian district hospital between 1. 1. 1984 and 31. 8. 1992 for peptic ulcer are retrospectively analyzed. 293 patients were admitted with a history of bleeding ulcers. Endoscopic haemostasis was achieved in 91 of 130 (70%) patients with active haemorrhage (Forrest Ia, Ib). For the other 39 patients with active haemorrhage as well as for 16 of 65 patients with signs of previous bleeding (Forrest II) emergency surgery was necessary. 33 patients were admitted for perforated ulcers and all underwent emergency surgery. Distral gastric resections were performed in 98% of cases (54/55) with bleeding ulcers and in 91% of cases (30/33) with perforated ulcers. The surgically treated patients had a high percentage of accompanying illness and females were significantly older (mean 68 years) than males (55 years) (p < 0.01). Postoperative mortality was 9.1% (5/55) for bleeding peptic ulcers and 6.1% (2/33) for perforated ulcers. Furthermore, mortality was zero in patients younger than 60 years (0/44), but 15.9% (7/44) in patients older than 60 years. Distal gastric resection was chosen as standard procedure for emergency operations.
对胃十二指肠溃疡急性并发症的外科手术，从危险因素和死亡率方面进行了研究。对1984年1月1日至1992年8月31日期间因消化性溃疡急诊入住奥地利一家地区医院的病例进行回顾性分析。293例患者因溃疡出血病史入院。130例活动性出血患者（福里斯特Ia、Ib级）中有91例（70%）经内镜止血成功。另外39例活动性出血患者以及65例有既往出血迹象患者（福里斯特II级）中的16例需要急诊手术。33例患者因溃疡穿孔入院，均接受了急诊手术。98%（54/55）的出血性溃疡病例和91%（30/33）的穿孔性溃疡病例进行了远端胃切除术。接受手术治疗的患者合并症比例较高，女性患者（平均68岁）明显比男性患者（55岁）年龄大（p<0.01）。消化性溃疡出血患者术后死亡率为9.1%（5/55），溃疡穿孔患者术后死亡率为6.1%（2/33）。此外，60岁以下患者死亡率为零（0/44），但60岁以上患者死亡率为15.9%（7/44）。远端胃切除术被选为急诊手术的标准术式。
