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[中老年溃疡性胃肠道出血的治疗]

[The treatment of ulcerative gastrointestinal hemorrhages in the middle-aged and elderly].

作者信息

Serova L S, Astashov V L

出版信息

Vestn Khir Im I I Grek. 1996(1):30-3.

PMID:8753955
Abstract

Under analysis were results of treatment of 123 patients, 60 years of age and older who had ulcerous gastro-intestinal bleedings. Emergency operations were performed on 46 patients, postponed operations on 30 patients and there were 47 planned operations. Out of 38 patients operated upon for resection of the stomach 5 patients had incompetent sutures of the stomach and duodenum, 4 patients had purulent complications, 9 patients died. Out of 11 patients subjected to simple suturing of the bleeding ulcer only one endured the operation, 10 patients died at the early postoperative period, 3 of them of recurrent bleedings. Vagotomy was made in 65 patients, 6 of them died. The amount of complications was minimum. Long-term results were followed up in all the alive patients at the period from 1 to 5 years. After suturing and dissection of the bleeding ulcer in none of 4 patients were observed good and satisfactory results. After resection of the stomach good results were obtained in 8 of 29 patients, satisfactory in 7 and unsatisfactory in 14 patients. Good long-term results were noted in all 59 patients after vagotomy.

摘要

对123例60岁及以上患有溃疡性胃肠道出血的患者的治疗结果进行了分析。46例患者接受了急诊手术,30例患者接受了延期手术,47例为计划性手术。在38例行胃切除术的患者中,5例胃和十二指肠缝合不当,4例出现化脓性并发症,9例死亡。在11例行出血性溃疡单纯缝合术的患者中,仅1例耐受手术,10例在术后早期死亡,其中3例死于复发性出血。65例患者进行了迷走神经切断术,其中6例死亡。并发症数量最少。对所有存活患者进行了1至5年的长期随访。在4例行出血性溃疡缝合和剥离术的患者中,均未观察到良好和满意的结果。在29例行胃切除术的患者中,8例取得了良好效果,7例效果满意,14例效果不满意。59例行迷走神经切断术的患者均取得了良好的长期效果。

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