Tactic of the treatment of gastroduodenal bleeding
R.R. SHIGABUTDINOV², A.V. ZAKHAROVA¹,², D.M. MIRGASIMOVA¹,², S.G. GLEBASHEVA², D.Zh. VASILIEV²
¹Kazan State Medical University, 49 Butlerov St., Kazan, Russian Federation, 420012
²Republican Clinical Hospital of the MH of RT, 138 Orenburgskiy Tract, Kazan, Russian Federation, 420064
Shigabutdinov R.R. — head of the department of endoscopy, tel. +7-917-267-31-56, e-mail: shigabutdinov1969@mail.ru
Zakharova A.V. — Cand. Med. Sc., Assistant of the Department of Surgical Diseases № 1, endoscopist, tel. +7-927-408-22-07, e-mail: zahanna.83@rambler.ru
Mirgasimova D.M. — Cand. Med. Sc., Associate Professor of the Department of Surgical Diseases № 1, Surgeon, tel. +7-904-667-45-51, e-mail: d.mirgasimova@yandex.ru
Glebasheva S.G. — endoscopist, tel. +7-905-312-75-22, e-mail: kfcnjxrf@yandex.ru
Vasiliev D.Zh. — endoscopist, tel. +7-917-286-40-74, e-mail: djavadvasilev@ yandex.ru
An experience of diagnosis and treatment of 460 patients with gastroduodenal bleeding is analyzed. Ulcer bleeding revealed in 172 (37,4%) and non-ulcer bleeding — in 288 (62,6%)) of cases. Endoscopic hemostasis was performed in 129 patients, including once, and the final was in 68% cases. Complex conservative therapy including substitution therapy, drug haemostasis, antisecretory drugs was successful in 286 patients. Emergency surgery in profuse and recurrent bleeding was performed in 36 patients, including gastric resection in 20 cases. Postoperative mortality was 33,3% (12 patients), general mortality was 4,7% (22 patients) Endoscopic hemostasis combined with complex conservative therapy in patients with gastroduodenal bleeding in most cases allows to avoid emergency surgery, which significantly reduces general mortality.
Key words: gastroduodenal bleeding, diagnostics, endoscopic hemostasis, surgical treatment.
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