胃大部切除术后并发大出血7例诊治体会

目的:探讨胃大部切除术后并发大出血的原因及处理措施。方法:对2000～2006年胃大部切除715例进行回顾性分析,对其中并发大出血7例纤维内镜检查。结果:7例中吻合口出血3例,胃残端缝闭处出血1例,吻合口多发性溃疡出血(毕2式吻合空肠侧)旷置的十二指肠球部溃疡出血1例,应激性溃疡1例,除应激性溃疡1例经保守治疗痊愈,其余6例均经再次手术治疗。结论:胃大部切除并发大出血多由于术中处理措施不当造成,出血量大,多需再次手术处理。

Diagnosis and treatment of subtotal gastrectomy accompanied by severe bleeding in 7 cases

Objective:The aim of this study was to investigate the cause of subtotal gastrectomy accompanied by severe bleeding and its measures of managemant.Methods:715 patients undergoing subtotal gastrectomy in faculty between 2000 and 2006 were analysed retrosepctively,in which all the 7 cases developing severe bleeding were performed fiberendoscopy.Results:Of the 7 patients with severe bleeding,3 cases occurred in the anastomotic site,1 case in the suture site of gastric stump,1 case was multiple ulcerative bleeding in the anastomotic site,1 case was interraption duodenobulbar ulcerative bleeding and only one was related to stress ulcer.Among them,only one whose bleeding was related to stress ulcer was cured through conservative treatment,all the rest 6 patients were performed surgical treatment again.Conclusion:Major severe bleeding after subtotal gastrectomy was due to the inadequate treatments during operation,always large hemorrhage,most of them had to be operated again.