Balafrej S, Echarrab E M, el Ounani M, Mdaghri J, Amraoui M, el Alami F H, Errougani A, Benchekroun B A, Chkoff M R
Service des Urgences Chirurgicale Viscérale, CHU Ibn Sina, Rabat, Maroc.
J Chir (Paris). 1997;134(9-10):406-9.
From 1986 to 1996, 557 patients are treated for acute ulcer bleeding. The sex ratio is five to one for men, the average age is 40 years old. The duodenal ulcer is revelated by haemorrhage in 25.8%. 181 patients underwent a surgical operation (32%). This percentage is higher that those encountered in the literature, due probably to our specific context (patients from low socioeconomic level, can not afford medical treatment, medical surveillance or control, lack of blood products in emergency. The most practiced surgical treatment is weinberg operation: "Troncular Vagotomy" with "pyroloplasty" and "ulcer sean" practiced in 86.1% of the cases; "Troncular Vagotomy" with "Gastro-intestinal anastomosis" is operated in 7.7% of the cases; "Superselective Vagotomy" and "Seromyotomy" is practiced in 3.8%, with the "Antroduodenectomy" is practiced in 1.1% of the cases. The overall death rate observed is about 4% this value increase to 11% after surgical treatment. This death rate is lower than the literature, that's probably anociated the fact that most of our patients are young and do not hold severe weaknesses. This study indicates that mortality was related to the patient's age, the patient's condition and recurrent haemorrhages.
1986年至1996年期间，557例患者接受了急性溃疡出血治疗。男女比例为5比1，平均年龄为40岁。十二指肠溃疡出血的发生率为25.8%。181例患者接受了手术（32%）。这一比例高于文献中报道的比例，可能是由于我们的特殊情况（患者来自社会经济水平较低的阶层，负担不起医疗、医学监测或控制费用，紧急情况下缺乏血液制品）。最常用的手术治疗方法是温伯格手术：86.1%的病例采用“迷走神经干切断术”加“幽门成形术”和“溃疡清创术”；7.7%的病例采用“迷走神经干切断术”加“胃肠吻合术”；3.8%的病例采用“超选择性迷走神经切断术”和“浆膜切开术”，1.1%的病例采用“胃十二指肠切除术”。观察到的总体死亡率约为4%，手术后这一数值升至11%。该死亡率低于文献报道，这可能与我们大多数患者年轻且没有严重虚弱状况这一事实有关。这项研究表明，死亡率与患者年龄、患者状况和反复出血有关。
