脊柱侧凸三维矫形术后并发应激性溃疡

目的：探讨脊柱侧凸矫形术后并发应激性溃疡的相关因素及治疗和预防措施。方法：回顾性分析2例脊柱侧凸矫形术后并发应激性溃疡患者的临床资料，1例行脊柱前路松解加颅骨一骨盆牵引术，1例行脊柱前路矫形融合术。结果：2例患者经去除应激因素、全身支持治疗、胃肠减压、管内投放硫糖铝混悬液、同时静脉滴注制酸剂或H2受体拮抗剂后均痊愈。结论：脊柱侧凸术后并发应激性溃疡是一种严重并发症，应积极进行全身及局部治疗。对脊柱侧凸矫形，术后出现频繁严重呕吐或精神紧张的患者，应早期预防。

Stress Ulcer after Surgery of Scoliosis

Objective: To investigate the treatment and prophylaxis of stress ulcer related to surgical correction of scoliosis and its intrinsic factors.Methods:The clinical feature of two patients presented stress ulcer after surgical correction of scoliosis were retrospectively reviewed.In first case,the stress ulcer occurred during the halo-pelvic traction following the anterior spinal release,in another case the patients underwent the anterior CDH spinal instrumentation.The surgery were performed both through intra-thoracic and retroperitoneal approach.Results:The two patients recovered after eliminating stress factors,general supporting,drainage with nasogastric tube,intragastric sucralfate,and intra-venous antacids or H_2 blockers.Conclusion:Stress ulcer with bleeding is a severe post-operative complication after surgical correction of scoliosis.Positive general and localized enterogastrial therapy is proved to be effective.Stress ulcer prophylaxis is necessary especially for those through anterior retroperitoneal approach and presenting severe gastric or psychiatric symptoms.