胃大部切除对于急性非静脉曲张性上消化道出血的长期疗效分析

Analysis of Long Term Clinical Effect of Subtotal Gastrectomy for Treatment of Acute Non Varicose Hemorrhage of Upper Gastrointestinal Tract

目的:探讨胃大部切除对于急性非静脉曲张性上消化道出血的长期治疗效果。方法:回顾性分析2006年1月-2008年12月本院136例急性非静脉曲张性上消化道出血患者的临床资料,依据治疗方式不同分为两组,其中采用胃大部切除手术治疗的64例患者为观察组,采用非手术治疗的72例患者为对照组。治疗后随访5年,比较两组长期疗效。结果:观察组近期治疗总有效率为98.44%,略高于对照组的91.67%,但差异无统计学意义(P>0.05);观察组不良情况发生率为6.25%,稍高于对照组的5.56%,但差异无统计学意义(P>0.05);观察组5年内再次出血发生率为3.13%,明显低于对照组的34.72%,差异有统计学意义(P<0.05);观察组糖尿病并发率为1.56%,明显低于对照组的15.28%,差异有统计学意义(P<0.05)。结论:胃大部切除治疗急性非静脉曲张性上消化道出血具有可靠的长期疗效,并可预防患者并发糖尿病,值得临床推广。

Objective： To discuss the long term clinical effect of subtotal gastrectomy for treatment of acute non varicose hemorrhage of upper gastrointestinal tract.Method： Clinical data of 136 patients with acute non varicose hemorrhage of upper gastrointestinal tract in our hospital from January 2006 to December 2008 were retrospectively analyzed. According to different treatment methods, these patients were divided into two groups, the observation group with 64 cases who were given subtotal gastrectomys and the control group with 72 cases who were given non-surgical treatments. They were given 5 years follow-up visits after treatments, and long term clinical effects of the two groups were compared.Result： Short term total effective rate of the observation group was 98.44%, slightly higher than 91.67% in the control group, but there was no statistically significant difference （P〉0.05）; occurrence rate of adverse reactions of the observation group was 6.25%, slightly higher than 5.56% in the control group, but there was no statistically significant difference （P〉0.05）; recurrence rate of bleeding within 5 years of the observation group was 3.13%, obviously lower than 34.72% in the control group （P〈0.05）; diabetes complication rate of the observation group was 1.56%, obviously lower than 15.28% in the control group （P〈0.05）.Conclusion： Subtotal gastrectomy has a reliable long term clinical effect for treatment of acute non varicose hemorrhage of upper gastrointestinal tract and it can also prevent complication of diabetes, so it is worth of being popularized clinically.