肝源性消化性溃疡的发病机理探讨及并发症治疗

PATHOGENIC STUDY OF HEPATOGENIC PEPTIC ULCER AND TREATMENT OF COMPLICA-TIONS

为探讨肝源性消化性溃疡的发病机理及其治疗原则,对58例肝源性消化性溃疡患者采用了彩色多普勒超声仪连续监测其门静脉血流量(24例),测定门静脉压力(8例)、血中组织胺浓度(8例)、溃疡灶旁胃泌素含量(9例)及幽门螺杆菌(58例)。58例中经手术治疗13例,非手术治疗45例。结果:门静脉血流量为1060.9±96 ml/min,门静脉压力为3.77±2.51 kPa,周围血组织胺浓度为0.70±0.31μmol/L。溃疡灶旁3cm及5cm处胃泌素含量分别为2195.6±1043.89ng/L。和2140.3±978.5ng/L,幽门螺杆菌阳性率为80%。全组患者治疗均获良好疗效,无1例死亡。本研究结果提示:肝源性消化性溃疡的发病与上述因素密切相关;治疗原则以非手术治疗为主,对止血无效和穿孔者则应行手术治疗。

The study of relation between hepatogenic peptic ulcer and portal hypertension,transmitter metabolic disturbance,hepatic insufficiency and infection ;and the therapeutic principles of complications of peptic ulcer are described. Twenty four of 58 patients with hepatogenic peptic ulcer were examined by color Doppler ultrasound. Portal venous flow volume (24 cases) was 1060. 9±96ml/min. Portal venous pressure(8 cases)was 3. 77±2. 51 kPa tested during operation.Histamine concentration(8 cases) was 0. 70±0. 31μmol/L in peripheral blood. The gastrin contents of 9 cases tested 3cm,5cm away from the ulcer were 2195. 6 ± 1043. 89ng/L and 2140. 3±978. 5ng/L respectively. H pylori positive rate was 80% in 58 cases. The therapeutic results were satisfactory with no death. The results suggest that pathogenesis of hepatogenic peptic ulcer is closely related to these factors foresaid. The treatment is nonsurgical and massive hemorrhage or perforation once occurs,surgical treatment is necessary.