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題 名 | Clinical Experience in the Treatment of Ulcer-induced Gastric Outlet Obstruction in Seven Children=幼童消化性潰瘍造成胃出口阻塞的治療 |
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作 者 | 黃福辰; 莊錦豪; 高常發; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷 期 | 41:4 民89.07-08 |
頁 次 | 頁189-192+229 |
分類號 | 417.624 |
關鍵詞 | 幼童; 胃出口阻塞; 消化性潰瘍; Children; Gastric outlet obstruction; Peptic ulcer disease; |
語 文 | 英文(English) |
中文摘要 | 消化性潰瘍造成胃出口阻塞罕見於幼童。從西元1987到1998,高雄長庚兒童醫院治療七位消化性潰瘍造成胃出口阻塞的幼童,包括六位男孩一位女孩,平均年齡爲兩歲八個月,其中五位接受主幹迷走神經切除(四位加上胃幽門重整,一位加上胃實切除),開刀原因是對藥物(H2-blockers)治療無效,術後除慢性腹瀉及輕微腹痛外,無其他併發症及死亡案例;最後二例則是成功地以口服Omeprazole或併用抗生素來減絕胃幽門螺旋桿菌,而在短時間內治癒的案例,非但可縮短住院天數並能讓病人早點進食。雖然手術治療在處理消化性潰瘍造成胃出口阻塞上有其優點,但從我們的病例回顧,則顯示強化藥物治療即可解決問題的趨勢。 |
英文摘要 | Peptic ulcer disease complicated with gastric outlet obstruction is rare in children. The experience in the treatment in children is limited. From 1987 to 1998, 7 children with gastric outlet obstruction due to peptic ulcer disease were encountered in our hospital. The 5 patients treated from October 1987 to May 1997 underwent truncal vagotomy, combined with pyloroplasty in 4 patients and antrectomy in 1. The indications for operation were failure of treatment with a histamine 2 (H2)-receptor antagonist. The remaining 2 patients, treated from June 1997 to October 1998, were successfully treated with oral omeprazole with or without the addition of antibiotics. These 2 patients had shorter hospital stays and could tolerate feeding earlier than those treated with truncal vagotomy. Although surgical treatment has merits in the management of children with peptic ulcer disease complicated with gastric outlet obstruction, in light of our cases we disclosed the trend toward intensive medical treatment. |
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