晚期血吸虫病上消化道出血情况的调查

A SURVEY OF ADVANCED SCHISTOSOMIASIS PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING

调查了4950例晚血,709例(14.3％)发生过上消化道出血。已切脾者有出血史的532例中,术前出血338例,268例(79.3％)术后未再出血,术后复发出血70例(20.7％)。切脾前无出血史者2781例,术后发生出血的194例(7％)。提示单纯脾切除对防治上消化道出血有一定效果,但术前有出血,术后再出血的发生率较术前无出血者高。对近年有出血史的50例晚血作了纤维胃镜检查,74％的患者伴有胃十二指肠病变.并对晚血患者上消化道出血的防治方法进行了探讨。

Among 4 950 advanced schistosomiasis patients examined, 709 (14.3%) had upper gastrointestinal bleeding, and in patients who had been treated with splenectomy, 532 presented history of bleeding. Of the 338 cases with a history of bleeding, 268(79.3%) ceased bleeding after operation and 70 cases (.20.7%) bled again. In 194 cases (7%) who had no history of bleeding before operation, bleeding occurred, suggesting that simple splenectomy has certain effect in preventing upper gastrointestinal bleeding, but the incidence of bleeding is higher in those who had a history of bleeding before operation. Gastrofibroscopic examinations in 50 cases who bled recently indicated that 74% of the patients had gastro-duodenal lesion as a concomitant disease.Prevention and treatment of upper gastrointestinal bleeding of advanced schisto somiasis patients are discussed.