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目的:通过6例小儿烧伤后并发上消化道大出血的临床分析,探讨用手术治疗降低其发病率和病死率的方法。方法:6例3～7岁患儿,伤后4～10天出现上消化道大出血,经保守治疗失效后,采取早期手术治疗。术中见溃疡位于十二指肠球部后壁,出血活跃,手术均采用毕Ⅱ氏胃大部切除空肠吻合术;对溃疡面大者,切除十二指肠溃疡的同时,结扎出血区上一级供血动脉,并反折十二指肠前壁关闭十二指肠残端。结果:经早期手术治疗,治愈5例,死亡1例.病死率减少,住院时间缩短。结论:Curling’s 溃疡和上消化道大出血与休克、感染密切相关。早期手术治疗是降低病死率积极有效的方法。
Objective: To investigate the surgical treatment of reducing the incidence and mortality of 6 cases of pediatric burns complicated by upper gastrointestinal bleeding. Methods: Six cases of children aged 3 to 7 years, 4 to 10 days after injury appeared upper gastrointestinal bleeding, conservative treatment fails, take early surgical treatment. Surgical see ulcer in the posterior wall of the duodenal bulb, hemorrhage, surgery are used to complete the completion of Section Ⅱ Ⅱ jejunostomy anastomosis; large ulcer, duodenal ulcer resection at the same time, the junction of the bleeding area A blood supply artery, and the anterior fracture of the duodenum off the duodenal stump. Results: After the early surgical treatment, 5 cases were cured and 1 died.The mortality rate was reduced and hospitalization time was shortened. Conclusion: Curling’s ulcer and upper gastrointestinal bleeding are closely related to shock and infection. Early surgical treatment is a positive and effective way to reduce mortality.