胃切除患者近期上消化道大出血原因分析与观察

对14例胃大部切除术后近期上消化道大出血病例资料进行回顾性分析、经验总结。本组14例中吻合口出血4例．病灶遗漏出血4例，残胃粘膜损伤2例，残胃肠套叠出血2例，十二指肠残端出血1例，原因不明出血1例，均再次手术止血。痊愈出院。认为胃大部切除后近期上消化道大出血原因多为吻合口出血及病灶遗漏引起，观察护理要点：术后重视患者主诉．观察生命体征、腹部体征、胃肠减压情况，可及时发现上消化道大出血。保证患者获得良好恢复。

Courses analysis and observation of patients with recurrent massive hemorrhage in the upper gastrointestinal tract after subtotal gastrectomy

In this paper, a retrospective review was carried out on 14 cases of recurrent massive hemorrhage in the upper gastrointestinal tract after subtotal gastrectomy. Among them, 4 had anastomotic bleeding, 4 dismissed bleeding, 2 bleeding in injured gastric remnant mucosa, 2 bleeding from gastrointestinal interssuception, 1 bleeding in duodenum stump, 1 unknown bleeding, all reoperated on and discharged after cure. They hold that the recurrent massive hemorrhage in the upper gastrointestinal tract after subtotal gastrectomy is mainly caused by anastomosis and ignorance of foci and the nursing keys are in postoperative attention to patients' complaints, observation of vital signs and abdominal signs, conditions of the peptic tube, which help timely to find recurrent massive hemorrhage of the upper gastrointestinal tract and ensure the better recovery.