上消化道大出血术后再出血的教训和治疗体会(附56例报告)

目的探讨上消化道大出血术后再出血应吸取的教训和处理对策。方法对56例上消化道大出血术后再出血的原因进行分析。结果再次手术37例,治愈33例(89.2%),死亡4例(10.8%);经腹腔内动脉插管介入治疗2例,止血成功1例,另1例再手术治愈;非手术治疗18例,治愈10例(55.6%),死亡8例(44.4%)。12例死亡病人再次出血距首次手术时间均在48小时内。结论对该类病人采取再手术与否,关键是看再出血的部位和原因以及非手术疗法止血的效果,应掌握好再手术的时机和正确的探查方法。

The reasons and treatment of recurrent bleeding after surgery on the massive hemorrhage of the upper digestive tract

Objective To explore the reason and management of recurrent bleeding after surgery on massive hemorrhage of the upper digestive tract.Method Analysis the reasons of 56 patients with rebleeding after surgery on the hemorrhage of the upper gastrointestinal tract.Results There were 37 of 56 cases under- went reoperation.33 were recovered,and 4 died,Two patients treated by transarterial embolization,one was treated successfully,another required reoperation.In patients received non-surgery management,10 of 18 recovered eight died.The rebleeding times of all 12 died patients were within 48 hours after the first op- eration.Conclusions The choice of operation or non-operation was determined by the position and the reason of rebleeding,Handing the chance and the method of re-operation were important too.