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目的 :提高对Dieulafoy病的早期诊断率及探讨对其合适的治疗方法。方法 :回顾性分析本院 1 984年 1月至 1 999年 6月收治的 8例Dieulafoy病患者的临床资料。 结果 :占同期上消化道大出血的 1 .9% ( 8/4 2 1 )。胃镜确诊 3例 ,手术探查确诊 5例。胃镜局部注射硬化剂止血 2例 ,其中 1例 6h后再次出血中转手术。手术治疗7例 ,行破裂血管缝扎术 3例 ,胃局部楔形切除术 3例 ,近端胃部分切除术 1例。 8例中 7例治愈 ,1例术后死于多器官功能衰竭。病死率为 1 2 .5% ( 1 /8)。结论 :掌握Dieulafoy病的特点 ,提高早期诊断率和及时手术处理非常重要。术式以胃局部楔形切除和破裂血管缝扎术较为实用。
Objective: To improve the early diagnosis of Dieulafoy disease and to explore its appropriate treatment. Methods: The clinical data of 8 patients with Dieulafoy disease treated in our hospital from January 1984 to June 1999 were retrospectively analyzed. Results: The same period accounted for 1.9% of upper gastrointestinal bleeding (8/4 2 1). Gastroscopy diagnosed in 3 cases, surgical exploration diagnosed in 5 cases. Gastroscopy partial injection of sclerosing agent to stop bleeding in 2 cases, of which 1 case of bleeding after 6h transit surgery. Surgical treatment in 7 cases, ruptured vascular suture in 3 cases, 3 cases of local wedge resection in the stomach, proximal partial gastrectomy in 1 case. Seven of the eight patients were cured and one died of multiple organ failure after operation. Case fatality rate was 12.5% (1/8). Conclusion: To master the characteristics of Dieulafoy disease, improve the early diagnosis rate and timely surgical treatment is very important. Surgery to the local wedge resection of the stomach and ruptured vascular suture is more practical.