【摘要】 本组急性胃粘膜损害(AGML)44例继发于休克、创伤、败血症和药物等四类病因。根据原发疾患可将其分为出血性胃炎和应激性溃疡两类,此种分类在临床上有实用价值。 部份出血性胃炎可经非手术疗法治愈(34.6％),多数经手术治愈(53.8％);然而应激性溃疡病程凶险,死亡率高达55.6％。 发病后先用抗酸剂、甲氰咪呱、冰水洗胃等非手术疗法处理出血与休克。本组有4例患者经用甲氰咪呱控制了出血,说明其为有效之预防和治疗措施。当非手术疗法不能控制出血时就需开腹探查,我们倾向于作迷走神经切断、胃大部切除加出血点缝扎。更多还原

【Abstract】 Shock, trauma, sepsis and drug are four major etiologic factors associated with AGML in 44 cases. These Iesions may be classified clinioally into two groups: 1. Hemorrhagic gastritis and 2. Stress ulcer.Some of hemorrhagic gastritis (34.6％) can be controlled medically, but majority of the cases (53.8％) can only be cured by operation. The stress ulcer is, however, more critical with a mortality rate as high as 55.6％.Initial management should consist of antacid drugs, cimetidine and gastric lavage with cold solutions and other measures to control shock and bleeding. Cimetidine has been provided effective prophylaxis and control of bleeding in four of our cases. Laparotomy should be performed if the nonoperative regimen fails. Vagotomy and subtotal gastrectomy with suture of the bleeding points is the operation of choice.更多还原