头颈部大手术后应激性胃溃疡出血的防治

Prevention and treatment of stress stomach ulcer bleeding in postoperative patients of head and neck surgery

报告８例病人术后发生应激性胃溃疡出血，以甲氰咪胍为主的非手术治疗获得满意效果，７例成功，ｌ例未控。另外，对２２例大型手术后的高危病人常规给予甲氰咪胍预防治疗，无１例病人发生应激性胃溃疡出血。作者认为，甲氰咪胍可以有效地治疗头颈部手术后应激性胃溃疡出血；对于手术创伤大、高龄、有胃病史或伴有心肺肝肾功能不全、感染等术后的高危病人，提倡常规应用甲氰咪胍预防应激性胃溃疡。

Abstract Eight patients with stress stomach ulcer bleeding after major head and neck surgery be-tween l980 to l994 were treated with cimetidine.Seven of them were fully recovered,one failed.Since l993, cimetidine had been admitted t0 twenty-two major postoperative cases to prevent stress ulcer. No stress stomach ulcer hemorrhage occurdin this group.The efficacy of cimetidine in the prevention and treatn1ent of stress stomach ulcer bleeding in postopera-tive patients was further confirmed. The pathogeny,preventiOn,mechanism and nonoperativetreatment of stress stomach ulcer bleeding were discussed.