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上部 消化管 出血患者에 對한 臨床的 觀察

A Clinical Review of Upper Gastrointestinal Tract Bleeding

대한외과학회지 1969년 11권 3호 p.177 ~ 189
朱相鏞, 李容珏, 李用雨,
소속 상세정보
朱相鏞 (  ) - 가톨릭醫大 外科學敎室
李容珏 (  ) - 가톨릭醫大 外科學敎室
李用雨 (  ) - 가톨릭醫大 外科學敎室

Abstract


A total of 238 cases of upper gastrointestinal tract bleeding were clinically reviewed, who were admitted to St. Mary´s Hospital, Catholic Medical College during three years from January 1965 to December 1967. They were composed of 30 childhood and 208 adult patients.
The following results were obtained:
1. Cases of upper gastrointestinal tract bleeding constituted 1. 72% of all patients admitted to departments of pediatrics, internal medicine and surgery. These were respectively 1.21% in childhood and 1.84% in adult patients.
2. Analysis of diagnosis revealed that the most prevalent disease was blood dyscrasias (50%) in childhood and peptic ulcer(44%) in adults. The others were duodenal ulcer(10%) and burn(10%) in pediatric age group and rupture of esophageal varices(23.4%), stomach cancer(14.1%), gastritis(6.0%) and postoperative bleeding(4.0%) in adults.
3. One third of pediatric patients were from 6 to 10 years of age. The greatest incidence of the, dseases in adults occured in the age group of 41 to 50 which comprised 27.5%. About 80% of the diseases occured after the age of 40 years.
4. Sex incidence showed that male to female ratio was 9:1 in childhood but 4:1 in adults.
5. Presenting signs of upper gastrointestinal tract bleeding revealed that melena occured in over 50% of pediatric patients but combined hematemesis and melena occured in over 50% of adults. The ratio of hematemesis to melena was 1:2 in adults and 1:3 in childhood.
6. The lowest values of hemoglobin and hematocrit were found in duodenal ulcer group in childhood which were an average of Hb 4.9gm% and Hct of 13%. In adults, the lowest value was found in postoperatve bleeding group and the highest in hemobilia.
7. Radiological diagnosis was established in 64.5% of all cases but in 38.4% of gastritis.
8. All the pediatric patients received only medical treatment and the death occured in 10%. In adults 53 patients were treated surgically and 125 medically and the death rate was 15.1% and 11.2% respectively.
9. About 50% of surgically treated patients had subtotal gastrectomy. Four had splenorenal of portacaval shunt opieratons.

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