外科治疗在急性胃粘膜病变所致上消化道大出血治疗中的地位

经确诊为急性胃粘膜病变所致上消化道大出血１９６例，其中出血性胃炎１３７例，应激性溃疡５９例。其治疗应首先去除与本病有关的致病因素，纠正循环量的不足，控制胃内ｐＨ值，增强胃粘膜的防御能力，经非手术治疗无效者则行手术治疗。应激性溃疡手术组死亡率为６．３％，出血性胃炎组为３３．３％。因此，对出血性胃炎的手术治疗应持慎重态度，对应激性溃疡大出血的手术治疗则应持积极态度。

THE IMPORTANCE OF SURGICAL TREATMENT OF MASSIVE UPPER GASTROINTESTINAL HEMORRHAGE CAUSED BY ACUTE GASTRIC MUCOSAL LESIONS

From 1984 to 1994,196 patients with massive upper gastrointestinal hemorrhage (hemorrhagic gastritis 137 cases,gastric ulcer 59 cases)caused by acute gastric mucosal lesions were treated in our hospital. As soon as the diagnosis was established,the stress factors in relation to acute gastric mucosal lesions and the factors damaging gastric mucosal barrier should be dispeled and hypovolemia should be corrected. In this group,the operative mortality were as follow: stress ulcer 6. 3%, hemorrhagic gastritis 33. 3%. According to this result,we consider that in cases of hemorrhagic gastritis the surgical operation must be considered with great care,but for stress ulcer with massive bleeding energetic surgical operation should be taken.