16例应激性溃疡的临床诊治体会

目的 报告应激性溃疡的临床诊治体会。方法 全组16例,男12例,女4例。术前均无溃疡病史,血红蛋白检查均正常。术后早期应用糖皮质激素9例,出血前发生肺不张、严重呼吸道感染、呼吸功能不全6例,低血容量休克5例,急性重症出血坏死性胰腺炎4例,食管癌、贲门癌术后6例,严重烧伤(80％(?)Ⅱ°)1例。14例保守治疗,2例保守治疗无效而手术治疗。结果14例经治疗后(2例手术治疗)痊愈出院,2例死亡。结论 应激性溃疡大出血患者多病情危重,难以忍受二次手术,死亡率约为50％,因此应采取有效的保守治疗,对于保守治疗无效、大出血休克或胃肠穿孔者应及时手术治疗。

Experiences of treating stress ulcer in 16 cases

Objective To summarize the experiences of treating stress ulcer. Methods A total of 16 patients with no past history of ulcer before admission and with normal hemoglobin volume were analyzed. Among them glucocorticoid was used in 9 cases, 6 cases had pulmonary atelec-tasis, serious infection of respiratory tract with respiratory insufficiency, 5 cases had hypovolemic shock, 4 cases had acute haemorrhagic pancreatitis, 6 cases were after operation of cancer of esophagus or cardia, 1 case was severe burn (80% ) . Fourteen cases were treated conservatively and 2 were treated operatively after failure of conservative treatment. Results Fourteen cases were cured(2 cases were treated by operation) and 2 cases died. Conclusion Patients with stress ulcer are usually serious and can not tolerate the operation. The mortality is about 50% . Therefore effective conservative treatment should be taken in time. Operative measures should be taken in time when conservative treatment is not effective.