СОВРЕМЕННЫЕ ПОДХОДЫ К ЛЕЧЕНИЮ ГАСТРОДУОДЕНАЛЬНЫХ КРОВОТЕЧЕНИЙ В НЕОТЛОЖНОЙ ХИРУРГИИ В СПЕЦИАЛИЗИРОВАННОМ ГОРОДСКОМ ЦЕНТРЕ

Abstract

Background. Gastroduodenal bleeding (GDB) is one of the most urgent problems of emergency abdominal surgery. The frequency of detection of bleeding of non-ulcer origin, which in the past was practically not diagnosed, has increased recently due to the widespread introduction of high-tech diagnostic techniques into clinical surgical practice. Diagnostic and therapeutic algorithms for GDB of ulcerative and non-ulcerative etiology are quite clearly defined, but the problem remains relevant due to the fact that the number of patients with acute GDB does not tend to decrease. The tactics of treating bleeding requiring emergency surgery remain debatable. Purpose. To evaluate the results of treatment of gastroduodenal bleeding of ulcerative and non-ulcerative origin requiring emergency surgery performed in a specialized city center for gastroduodenal bleeding. Material and methods. The experience of emergency care and treatment of 1061 patients with GDB in a specialized center is presented. Results. FGDS was performed on admission in all patients; ulcer bleeding was diagnosed in 809 (76.2%) patients; non-ulcer bleeding in 252 (23.8%) patients. Bleeding from gastric ulcers was detected in 227 (30.3%) patients, from duodenal ulcers – in 582 (69.7%) patients. Endohemostasis was performed for continued bleeding during FGDS. The treatment was based on the generally accepted complex of conservative therapy according to the clinical protocols for managing patients with GDB. Сonclusion. An analysis of the results of treatment of patients hospitalized in the city center for GDB showed that at the present stage endohemostasis is effective in 98.4% of ulcer bleeding and in 96.0% of non-ulcer bleeding.