تدبير القرحة الهضمية العرطلة
Abstract
تعرّف القرحة الهضمية العرطلة بأنها القرحة التي يزيد قطرها عن 2سم والتي تميزت بكونها الآفة الأكثر شدة من الداء القرحي الشائع لترافقها بالعديد من المضاعفات المهددة للحياة والتي قد يحتاج البعض منها تداخلاً جراحياً إسعافياً .
أجريت الدراسة في مشفى الأسد الجامعي باللاذقية خلال الفترة الواقعة ما بين عامــي 1997 – 2002 على /55/ مريضاً راجعوا قسمي الداخلية والجراحة .
80% من هؤلاء المرضى عولجوا معالجة محافظة, و20% منهم عولجوا معالجة جراحية علماً بأنه تم استبعاد المرضى الذين كشف لديهم قرحات خبيثة من الدراسة .
تميزت نتائج المعالجة المحافظة بأنها جيدة ونسبة مضاعفاتها قليلة جداً ، واقتصرت المعالجة الجراحية كعلاج أساسي فقط على القرحات العرطلة المترافقة باختلاطات مثل النزف, والانثقاب, وانسداد البواب, ونكس القرحة, أو فشل العلاج المحافظ حيث تميز العلاج الجراحي (وبدعم المعالجة الدوائية) بكونه كان شافياً .
The giant peptic ulcer is defined as the ulcer whose diameter is more than 2 cm and characterized by being a more severe lesion than the common ulcer disease because of it's accommodation with many life threatening complications which an urgent surgery my be required.
The study has been conducted in Al – Assad academic hospital during the period between 1997-2002 on 55 patients who were admitted in internal and surgical wards.
80% of those patients were treated as a conservative therapy and 20% were treated as a surgical therapy and it's known that the patients with malignant ulcers are put out of the study.
The results of the conservative treatment are good and it's complications are very little.
The surgical treatment is indicated as an essential procedure only when giant peptic ulcer is complicated.
For example:
- bleeding.
- Perforation.
- Pylori's obstruction.
- Ulcer's reccurence.
- Failure of conservative treatment.
The surgical treatment is being distinguished (with the support of medical therapy) for it's being therapeutic. (healing).
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