烧伤后上消化道应激性溃疡大出血手术治疗

A clinical study of surgical treatment for patients with upper gastrointestinal hemorrhagic stress ulcer after burn

目的 探讨烧伤后上消化道应激性溃疡大出血手术治疗的效果。方法 烧伤后上消化道应激性溃疡大出血患者１５ 例，烧伤面积（３８ ±１５） ％ ，出血部位１２ 例位于十二指肠，３ 例位于胃。手术时间在伤后４ ～１２ 天，手术方式为缝扎止血、幽门成形、选择性迷走神经切断、溃疡外旷置术或胃大部分切除术。结果 １５ 例中１３ 例治愈，２ 例死亡，其中１ 例死于术后败血症，另１ 例死于再出血并多器官功能衰竭。结论 手术治疗是烧伤后上消化道应激性溃疡大出血的有效治疗方法，对符合手术治疗的患者应尽早手术，以免延误时间，造成严重后果。

Objective To evaluate the effect of surgical treatment on upper gastrointestinal stress ulcer with bleeding after burn. Methods 15 patients with burn area of (38±15)% and with upper gastrointestinal hemorrhagic stress ulcer received surgical procedures, including sutured hemostasis, pyloroplasty, selective vagotomy, or subtotal gastrectomy, and so on, between 4 to 12 days after burn. Results 13 of 15 patients were cured but 2 died, one died from recurrent bleeding with multi organ failure, the another from septicemia. Conclusion Surgical operation is an effective treatment of upper gastrointestinal hemorrhagic stress ulcer and the patients with surgical indication should be operated as soon as possible in order to avoid serious outcome.