非手术治疗效果不佳的非静脉曲张性上消化道出血24例原因分析

Clinical analysis of 24 cases treated with surgical emergency for acute nonvariceal upper gastrointestinal bleeding

[目的]分析非静脉曲张性上消化道出血经非手术治疗效果不佳的原因,分享急诊手术治疗体会。[方法]回顾性分析经非手术治疗效果不佳的24例非静脉曲张性上消化道出血患者临床资料。[结果]24例中胃十二指肠溃疡出血共14例(占58.33%),≥60岁者12例(占50.00%),男性22例(占91.67%)。24例经急诊外科手术治疗治愈22例,死亡1例,病危自动出院1例。[结论]胃十二肠溃疡出血、年龄、性别是非手术治疗后止血效果不佳或失败的主要原因,急诊外科手术治疗仍是抢救患者的重要方法。

[Objective]To investigate the cause of acute nonvariceal upper gastrointestinal bleeding（ANUGIB）and share emergency surgical treatment experience in our hospital.[Methods]This is a retrospective analysis of a nine-year period from 2005 to 2013,twenty-four cases were treated with the emergency surgical for ANUGIB and the clinical data were analyzed.[Results]In 24 cases,14cases（58.33%）were gastrodude ulcer bleeding,12cases（50.00%）were≥60years old,22cases（91.67%）were male.In 24 cases,22cases were cured,one case died,one case discharged automatically.[Conclusion]With the progress of pharmacologic and endoscopic therapy,the non-surgical therapy has become the first choice for most patients with ANUGIB.However,emergency surgery is the important way to rescue patents when it is impossible to achieve hemostasis by pharmacologic and endoscopic therapy or if rebleeding occurred when the conservative treatment fails.