摘要
目的 比较急诊内镜和手术治疗对上消化道溃疡反复出血患者的治疗效果。方法64例患者治疗前经内镜证实上消化道溃疡出血，均有两次以上出血史。内镜治疗组（32例）采用10％孟氏液20-40ml对溃疡面进行喷洒或用热探头电凝止血；外科手术组（32例）行胃大部分切除术或溃疡单纯切除术。结果 内镜治疗组：长期治愈25例（78．1％）；治疗半年内再次出血5例；治疗失败1例；治疗时发生穿孔1例，临床消化道症状缓解者21例（65．6％）。外科手术组：出血长期治愈27例（84．4％），半年内再次出血2例，60天内死亡3例，手术后并发症6例（18．8％），长期有消化道症状者18例（56．3％）。结论 与外科手术治疗相比，急诊内镜治疗上消化道溃疡反复出血的疗效相当，但在缓解症状和减少并发症等方面优于外科手术。
Objective To evaluate the outcome of emergent endoscopic and surgical hemostasis for recurrent hemorrhage of gastroduodenal ulcer. Methods A series of 64 patients with bleeding gastroduodenal ulcer were divided into endoscopic （n=32） and surgical （n=32） hemostasis groups. Injection of Monsell＇s solution （10%, 20-40ml） or electric diathermy was applied for endoscopic hemostasis. Partial gastrectomy or simple resection of ulcer was performed in surgical group. Results Among patients with endoscopic treatment, 25 （78.1%） cases achieved long term healing, 5 rebleeded in half a year, one failed to treatment, one,had perforation during manipulation and 21 （65.6% ） were free of gastrointestinal symptoms. Among patients with surgical treatment, 27 （84.4%） achieved long term healing, 2 rebleeded in half a year, 3 died in 60 days after operation, 6 had surgical complications and 18 （56. 3%） complained of gastrointestinal symptoms. Conclusion Compared with the surgical treatment, endoscopic hemostasis is an effective treatment of bleeding gastroduodenal ulcer with more alleviation of symptoms and less complications.
出处
《东南国防医药》
2006年第2期95-96,共2页
Military Medical Journal of Southeast China
关键词
胃十二指肠溃疡
反复出血
内窥镜
手术
治疗
Gastroduodenal ulcer
Recurrent bleeding
Endoscopy
Surgery
Treatment
作者简介
胡维杰，男，1963年生，江苏南京人，本科，副主任医师，从事消化内镜检查与治疗工作。
