胃部分切除术后早期大出血再手术12例临床分析

摘要

Objective: To explore the cause and reoperation method of massive heamorrhage after partial gastrectomy at early stage. Methods: The clinical data of 12 patients with massive hemorrhage after partial gastrectomy at early stage treated by reoperation were retrospectively analyzed from Sep. 2000 to Sep.2010. Results: 6 cases were anastomotic bleeding, 2 cases were duodenal exclusion and residual gastric stress ulcer bleeding, 1 case was omission lesions and residual gastric mucosal injury bleeding. Conclusion: Anastomotic bleeding was major cause of early hemorrhage after subtotal gastrectomy, and open gastrointestinal anastomosis can effectively prevent postoperative bleeding after subtotal gastrectomy. It is very important to master right surgical indications and surgical methods.%　　目的：探讨胃部分切除术后早期大出血的原因和再手术方法。方法：回顾性分析我院2000年9月至2010年9月收治的12例胃部分切除术后早期大出血再手术病人的临床资料。结果：吻合口出血6例，旷置十二指肠溃疡和残胃应激性溃疡出血各2例，遗漏病灶、残胃黏膜损伤出血各1例。结论：吻合口出血是胃部分切除术后早期出血的多见原因，胃肠开放性吻合能有效预防胃部分切除术后出血，必须正确掌握再手术指征和手术方法。