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目的探讨十二指肠球后溃疡大出血急诊手术治疗的临床疗效及对术后再出血的预防措施。方法回顾性分析我院2001年1月至2011年8月期间18例术中确诊的十二指肠球后溃疡并大出血手术患者的临床资料。结果 18例急诊手术,其中Nissen法12例,Graham法5例,Bancroft法1例。全部顺利成功完成手术,术后第1天再出血1例,经保守治疗治愈,均痊愈,无一例患者死亡。结论对于经保守治疗无效的上消化道大出血,急诊手术是挽救患者的关键,术后正确静脉使用奥美拉唑,维持胃内pH值>6.4是防止术后再出血的重要保障。
Objective To investigate the clinical efficacy of emergent surgery for the treatment of post-duodenal ulcer bleeding and the preventive measures for postoperative hemorrhage. Methods The clinical data of 18 patients with postoperative ulcer and bleeding after operation of duodenal bulb in our hospital from January 2001 to August 2011 were retrospectively analyzed. Results 18 cases of emergency operation, including 12 cases of Nissen method, Graham method in 5 cases, Bancroft method in 1 case. All successfully successfully completed the operation, 1 day after surgery, another case of bleeding, cured by conservative treatment, were cured, none of the patients died. Conclusion For the patients with upper gastrointestinal bleeding after conservative treatment, emergency surgery is the key to saving the patient. After the operation, omeprazole is used intravenously correctly to maintain the intragastric pH> 6.4 as an important guarantee to prevent postoperative bleeding.