颅脑损伤并发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防治方法.方法 回顾性分析625例颅脑损伤后上消化道出血的病例,在治疗原发伤基础上,采用止血、抑酸、保护胃粘膜等对症处理,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 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 防治的重点是治疗颅脑损伤和保护胃粘膜,常规处理效果满意,但必要时应及时进行手术止血等治疗,以迅速控制出血.

Prevention and Treatment of Upper Gastrointestinal Hemorrhage Induced by Craniocerebral Injury(Report of 625 Cases)

Objective To explore the prevention and treatment of upper gastrointestinal hemorrhage after craniocerebral injury. Methods The clinical data of 625 patients with upper gastrointestinal hemorrhage after craniocerebral injury were analysed retrospec-tively. On the basis of treating primary injury, the curative measures including hemostasis, inhibiting acid and protecting gastric mucous membrane were adopted. The local hemostasis under an endoscope was performed in 8 patients and 5 received partial gastrectomy. Results The hemorrhage was completely controlled in 572 patients, alleviated in 36, unchanged in 5 and 12 died. The hemorrhage was controlled in 20 patients by atropine, in 6 by the hemostasis under the endoscope and in 4 by partial gastrectomy. Conclusions The emphasis of prevention and treatment of gastrointestinal hemorrhage should include treating craniocerebral injury and protecting gastric mucous membrane in the patients with craniocerebral injury. Generally speaking, the conservative treatment is of effect on the gastroin-testinal hemorrhage. The special measures such as surgery should be performed in order to control rapidly bleeding if necessary.