胃切除术后并发上消化道大出血的诊治分析  

Diagnosis and treatment of massive upper gastrointestinal hemorrhage after gastrectomy

作　　者：汪进国[1] 吴佩[1] 武健[1] 陈贤军[1] 瞿章[1] 茆家定[1] 梁林虎[1] 黄鹤[1] 

机构地区：[1]皖南医学院附属弋矶山医院胃肠外科,安徽芜湖241001

出　　处：《皖南医学院学报》2011年第4期277-279,共3页Journal of Wannan Medical College

基　　金：安徽省高校省级科学研究基金项目(KJ2011B193)

摘　　要：目的:探讨胃切除术后上消化道大出血的原因、诊断和治疗。方法:对我院2006年1月～2010年12月间收治的23例胃切除术后大出血患者的临床资料进行回顾分析。结果:本组中有10例行急诊胃镜检查,4例行超选择性血管造影检查,1例通过剖腹探查而得以诊断;有6例接受手术治疗,4例行超选择性血管栓塞治疗;治愈17例(73.9%),死亡6例(26.1%)。结论:超选择性血管造影及胃镜检查,有利于明确出血的部位及原因;选择恰当的治疗方式对防止再出血非常重要。Objective：To explore the causes,diagnosis and treatment of massive upper gastrointestinal hemorrhage after gastric resection.Methods： The clinical data were retrospectively analyzed in 23 cases with massive upper gastrointestinal hemorrhage after gastrectomy during Jan.2006 and Dec.2010.Results： Of the total 23 cases,10 received emergency gastroscopic examination,4 underwent superselective angiography and 1 was confirmed by exploratory laparotomy.Six patients were managed by surgical procedure and 4,by superselective emblozation.Seventeen were cured（73.9%）and 6 were dead（26.1%）.Conclusions Superselective angiography and gastoscopy are effectively to identify the region and causes of hemorrhage,and right surgical intervention is essential to prevent rehemorrhage.

关 键 词：胃切除术 手术后并发症 出血 

分 类 号：R656.61[医药卫生—外科学] R619.1[医药卫生—临床医学]