颅脑损伤患者上消化道出血的预防和治疗(附625例报告)

目的探讨颅脑损伤后上消化道出血的预防措施及其治疗方法。方法回顾性分析625例颅脑损伤后上消化道出血的病例,在治疗原发伤病基础上,采用止血、制酸、保护胃黏膜等对症处理,同时应用阿托品治疗22例;胃镜下治疗8例;胃次全切除术5例。结果本组病例中,治愈572例,缓解36例,无效5例,死亡12例,其中阿托品治愈20例;胃镜下治愈6例;胃次全切除术治愈4例。结论预防和治疗的重点是消除颅脑损伤病灶和保护胃黏膜,常规处理方案效果满意,简单、经济且安全有效,但必要时应及时使用特殊治疗手段,以迅速控制出血病情。

Prevention and treatment of upper gastrointestinal hemorrhage complicated of head injury: report of 625 cases

Objective To investigate the prevention and treatment of upper gastrointestinal hemorrhage complicated of head injury. Methods Six hundred and twenty-five cases with head injury complicating upper gastrointestinal hemorrhage were retrospectively reviewed, Based on managing primary injury, hemostasis, inhibiting acid and protecting mucus were adopted, 22 received atropine, 8 were treated with focal hemostasis under endoscopy and 5 recieved partial gastroectomy. Results In this series 572 cases got the expected effect, of whom 20 were treated with atropine, 6 with endoscopy and 4 recieved partial gastroectomy, 36 regressed, 5 had no change, 12 died. Conclusions The emphasis of prevention and treatment focusing on removing the focus of injuried head and protecting gastric mucus, routine treatment is satisfying, easy, economic safe and effective, some special procedure should be carried on in time in order to control the condition if necessary.