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題名 | The Rik Factors Influencing Mortality in Emergency Operation for Bleeding Peptic Ulcer=影響消化性潰瘍出血例緊急手術死亡率之危險因子 |
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作者姓名(中文) | 王嘉修; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 20:4 1987.07[民76.07] |
頁次 | 頁314-323 |
分類號 | 416.2421 |
關鍵詞 | 消化性潰瘍出血; 緊急手術; 死亡率; |
語文 | 英文(English) |
中文摘要 | 自民國66年12月至民國74年12月止在長庚紀念醫院接受緊急手術之消化性潰瘍出血例一共有258位。這些緊急手術例佔全部出血例手術的40.9%。其中男性217例,女性41例。平均年齡是56歲(15-89歲)。手術死亡有34例,死亡率達13.1%,而同期間內擇期手術之死亡率僅1.3%。為探討影響術死率的危險因子,將緊急手術例做一回顧性之分析。具有影響手術死亡率的危險因子是高齡(≧60歲),急性潰瘍史,合併內科疾病,潰瘍位居十二指陽,和輸血超過4,000 ml。 若將病人自60歲為界分成高齡和非高齡兩組,高齡組之合併內科疾病,急性潰瘍史,和胃部潰瘍的比例皆大於非高齡組,另外手術也較常採用單純之縫合止血方法。雖然高齡組之總括術死率大於非高齡組,但是在有術前休克,有合併內科疾病,輸血量大於4,000 ml,或有急性潰瘍史等因子存在時,則兩組的術死率呈無意義差。高齡對術死率的影響,其重要性比其他危險因子為小。 |
英文摘要 | From December 1977 to December 1985, 258 patients received emergency operation for bleeding peptic ulcer (BPU) in Chang Gung Memorial Hospital. Included were 217 males and 41 females (sex ratio 5:1) with mean age of 56 years (range,15 to 89). The BPU location was the stomach in 134 cases, and the duodenum in 119 cases. Postoperative death occurred in 34 cases, a mortality rate of 13.1%. The risk factors that significantly influenced the operative mortality were old age (≧60 years), duodenal location, acute ulcer history, blood transfusion of more than 4,000 ml, and associated medical diseases. With regard to old age, the elderly had a higher incidence of associated medical diseases, gastric ulcer, acute ulcer history, and simple surgical procedures (suture ligation) than the younger. Overall mortality of the elderly was higher than that in the young. However the age factor did not significantly affect mortality in the presence of shock, associated medical disease, acute ulcer history, and blood transfusion of more than 4,000 ml. Thus old age is less important than other major risk factors in the inf1uence upon the operative mortality. |
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