Gastric Devascularization: A Useful Salvage Procedure for Massive Hemorrhagic Gastritis
Gastric Devascularization: A Useful Salvage Procedure for Massive Hemorrhagic Gastritis
复制标题
胃血管断流术：大出血性胃炎的一种有用的挽救手术
作者：
J. Richardson;J. Aust
由于弥漫性出血性胃炎（DHG）的常规手术治疗效果不佳，对21例患者进行了胃血管离断术的前瞻性评价。败血症、酒精中毒、激素滥用是常见的病因。尽管这些都是危重患者，但所有患者均通过该手术止血，只有2例（9%）再次出血。平均手术时间为84分钟。有2例手术并发症，无胃坏死发生。由于原发病，死亡率高（38%）。胃血管离断术是DHG患者的一种有用的挽救手术，因为它可以快速完成，并发症少，再出血率低，不会引起永久性后遗症。由于该手术导致严重的胃粘膜缺血，因此仅怀疑该机制作为“应激性溃疡”的原因的重要性。
Due to poor results with conventional operative therapy for diffuse hemorrhagic gastritis (DHG), a prospective evaluation of gastric devascularization was performed on 21 patients. Sepsis, alcoholism, and steroid abuse were the common etiologic factors. In spite of the fact that these were all critically ill patients, all stopped bleeding with this operation and only two rebled (9%). The average operating time was 84 minutes. There were two operative complications and gastric necrosis did not occur. The mortality was high (38%) due to the primary disease. Gastric devascularization is a useful salvage procedure for the patient with DHG because it can be accomplished rapidly, with few complications, has a low rebleed rate, and causes no permanent sequelae. Since this procedure causes severe gastric mucosal ischemia, it casts doubt only on the importance of this mechanism alone as the cause of “stress ulceration.”