Clinical Analysis Of Surgical Treatment Upper Peptic Ulcer Bleeding

Objectives:This research was a retrospective analysis to investigate the clinical features of Surgical Treatment Upper Peptic Ulcer Bleeding, which was helpful to the treatment of peptic ulcer bleeding associated.Methods:Clinical dates with upper peptic ulcer bleeding from 1 Jan.2006 to 30 Dec.2010 were collected from The First Affiliated Hospital of Shantou University Medical College. These variables include age, past history of whether peptic ulcer tract disease, past history of whether underlying disease, Forrset grades, Rockall grades, hemorrhagic shock, anaemia grades. The mortality, survival rate, complication rate were taken as statistical indicators for staticial analysis to compare the clinical effectiveness of various factors on acute obstructive peptic ulcer bleeding associated.Results:1.Clinical dates of 46 patients with upper peptic ulcer bleeding were collected. The diagnoses of pathology, 26 (56.5%) patients were gastric ulcer, 15 (32.6%) patients were duodenal ulcer, 5(10.9%) patients were complex ulcer. Thereinto 5(10.9%) patients were carcinomatous. Operation , 20 (43.5%) patients were gastroduodenostomy, 16(34.8%) patients were gastrojejunostomy, 4(8.7%) patients were radical gastrectomy, 3(6.5%) patients were Excision of ulcer of stomach, 3(6.5%) patients were anear stomach resection. Thereinto 8(17.4%) were pylorus spacious sets. From this research, 42(91.3%) patients were healed, 3 (6.5%)patients needed operation again and healed, 1(2.2%) patient was dead.2.In the Forrest stage I 32(69.6%) patients group , 5(10.9%) patients were occur complications, 1(2.2%) patient was dead. In the Forrest stage II 14(30.4%) patients group, 1(2.2%) patient occur complication, no one was dead. No significant difference was note in mortality and complication rates between Forrest stage I and Forrest stage II( P>0.05).3.In the Rockall grade 1~4, none occur complication and dead of the 21(45.7%) patient. There are 25(54.3%) patients in the Rockall grade 5~8, 6(13%) patients occur complications, 1(2.2%) patient was dead. No significant difference was note in mortality rates between Rockall grade 1~4 and Rockall grade 5~8 ( P>0.05).There was significant differences was note complication rates between the above two groups(P<0.05).4. No significant difference was note in mortality rates between hemorrhagic shock or not( P>0.05) . There was significant differences was note complication rates between the above two groups(P<0.05).5. No significant difference was note in mortality and complication rates between past history of whether peptic ulcer tract disease ( P>0.05).No significant difference was note in mortality and complication rates between ast history of whether underlying disease ( P > 0.05). There was significant differences was note complication rates between the above two groups(P<0.05).Conclusions:1.Reasonable and effective surgical treatment is crucial in improving the prognosis and survival rate of peptic ulcer bleeding, the fundamental treatment should be solving the obstruction and unobstructed drainage.2.Rockall grade is more valid than Forrest stage to realize the state of an illness. But this is not enough. We must combine patients’signs ,symptoms and blood bio-chemistry checking.3.Advanced age, underlying diseases and history of a bile duct or bile duct surgery are not contraindications for surgery of this disease, but higher requirements are needed for surgery and perioperative management.