Damanakis K, Schenk R, Dräger C
Bereich für Allgemeinchirurgie, Ferdinand-Sauerbruch-Klinikum Wuppertal-Elberfeld.
Zentralbl Chir. 1996;121(7):571-6; discussion 577.
The bleeding complications of gastric- and duodenal ulcers have not declined in the past 20 years. This is the leading factor for the unchanged lethality of this disease. We present our results in 31 patients with gastroduodenal ulcer bleeding. The mean age was 72, 1 years and the majority of patients had an advanced stage of ulcer disease with penetration in neighbouring organs. 8 of 31 patients had to be operated under emergency conditions within 6 h. 23 patients with high risk for re-bleeding were operated early elective (12-36 h); 11 of those were in a severe shock at the beginning of the operation. After control of bleeding by intra-and extraluminar ligature all patients underwent a primary resection (B I, B II or cardiofundectomy). The lethality was 12.9% (4/31), there was no re-bleeding. With the exception of one late duodenal insufficiency none patient had to be re-operated.
胃和十二指肠溃疡的出血并发症在过去20年中并未减少。这是该疾病致死率未变的主要因素。我们展示了31例胃十二指肠溃疡出血患者的治疗结果。平均年龄为72.1岁，大多数患者处于溃疡病晚期，溃疡已穿透至邻近器官。31例患者中有8例在6小时内接受了急诊手术。23例再出血高危患者接受了早期择期手术（12 - 36小时）；其中11例在手术开始时处于严重休克状态。通过腔内和腔外结扎控制出血后，所有患者均接受了一期切除术（毕Ⅰ式、毕Ⅱ式或贲门胃底切除术）。致死率为12.9%（4/31），无再出血情况。除1例晚期十二指肠功能不全外，无患者需要再次手术。
