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目的 :探讨上消化道大出血的治疗经验。方法 :对近 3年来收治的上消化道大出血 60例患者的治疗方法进行分析总结。结果 :保守治疗治愈 4 3例 ,其中包括十二指肠球部溃疡并出血 ,胃溃疡并出血 ,糜烂性胃炎 ,肝硬化食管静脉曲张破裂出血 ,胃次全切除术后出血及药物性胃出血 ;手术治疗 17例 ,包括胃癌并出血 ,胃神经鞘瘤并出血 ,贲门癌并出血 ,肝硬化食管静脉曲张破裂出血 ,十二指肠球部溃疡并出血 ,胃溃疡并出血。除 1例死亡外 ,其余 5 9例均为治愈出院 ,病死率 1 7%。结论 :急诊胃镜是上消化道大出血的首选诊断方法 ,除常见病引起的上消化道大出血外 ,应重视少见病所致的急性大出血。治疗上除恶性肿瘤外 ,均可经内科保守治疗。在保守治疗期间应掌握外科手术指征 ,这样才能提高治愈率 ,降低死亡率。
Objective: To investigate the treatment of upper gastrointestinal bleeding. Methods: The treatment of 60 cases of upper gastrointestinal bleeding in recent 3 years were analyzed and summarized. Results: conservative treatment of 43 cases, including duodenal ulcer and bleeding, gastric ulcer and bleeding, erosive gastritis, cirrhosis and esophageal variceal bleeding, subtotal gastrectomy and drug-induced gastric bleeding ; Surgical treatment of 17 cases, including gastric cancer and bleeding, gastric schwannoma and bleeding, cardia cancer and bleeding, cirrhosis of the esophageal variceal bleeding, duodenal ulcer and bleeding, gastric ulcer and bleeding. Except for one case of death, the remaining 59 cases were cured and discharged with a mortality rate of 17%. Conclusion: Emergency gastroscopy is the first choice of diagnosis of upper gastrointestinal bleeding, in addition to common upper gastrointestinal bleeding caused by common diseases, acute bleeding due to rare diseases should be emphasized. In addition to the treatment of malignant tumors, can be conservative treatment by internal medicine. During conservative treatment should be surgical indications, so as to improve the cure rate and reduce mortality.