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70年代中期H_2-受体拮抗剂广泛用以治疗消化性溃疡以来,能很有效地加速活动性溃疡愈合,由溃疡引起的急、慢性穿孔及幽门梗阻等并发症亦有所减少。但消化性溃疡合并急性大出血(PuMb)仍较常见,老年人因PuMb或出血手术后并发症的病死率仍为10%左右,因而有效、安全的内科止血实属必要。PuMb急诊内镜下可看到两种出血征象:即溃疡面有渗血、滴血或喷血的活动性出血;溃疡底部血管显露、血凝块、血痂的新近出血。后者再出血的可能性很大,据研究,血管显露者,再出血率约58%(54/93)。这种消化性溃疡的持续出血或再出血常导致手术或死亡。近年来对PuMb内科止血治疗有很大进展,现分述如下。
Since the mid-1970s, H 2 -receptor antagonists have been widely used to treat peptic ulcer, which can effectively accelerate the healing of active ulcer. The complications such as acute and chronic perforation caused by ulcer and pyloric obstruction are also reduced. However, Peptic ulcer complicated with acute massive bleeding (PuMb) is still common, and the mortality of PuMb or postoperative bleeding complications in the elderly is still about 10%. Therefore, effective and safe medical hemostasis is necessary. PuMb emergency endoscopy can see two signs of bleeding: the ulcer surface bleeding, bleeding or spurting of active bleeding; ulcer bottom of the blood vessels revealed blood clots, blood clots recent bleeding. The latter is very likely to rebleeding, according to the study, vascular revealed who rebleeding rate of about 58% (54/93). Persistent bleeding or rebleeding of this peptic ulcer often leads to surgery or death. In recent years, there has been great progress in the treatment of PuMb internal medicine, which is as follows.