[The surgical procedure in patients with hemorrhaging perforating gastroduodenal ulcers]. / Khirurgicheskaia taktika u bol'nykh s krovotochashchimi penetriruiushchimi gastroduodenal'nymi iazvami.

The paper presented the results of surgical treatment of 277 patients with bleeding penetrating gastroduodenal ulcers. Gastric location of the ulcer was revealed in 52 patients and duodenal location in 225 ones. More commonly used resections of the stomach according to a Billroth-I method or suprapyloric resections versus the resection of the stomach according to method Billroth-II when used in the patients with gastric location of the ulcers helped to reduce the mortality from 23.1 to 0%. The wide usage of organ-sparing operations combined with vagotomy reduced the lethal outcomes of the disease from 13 to 5.5% versus the resection of the stomach. The rate of bleeding relapses in the early postoperative period which followed the suture of penetrating gastroduodenal ulcers was 25.9%. The dissection of ulcers or their elimination from the alimentary tract could be regarded as the methods of choice in case of palliative treatment. Surgical treatment of penetrating gastroduodenal ulcers should be performed prior to bleedings. Planned operative intervention should be performed in patients with deep gastric ulcer with diameter of 1.5 cm and more and pyloroduodenal ulcers with diameter of more than 1 cm.

[The acid-base status and oxygen-transport function of the blood in patients in the early period after surgical interventions for ulcerative gastroduodenal hemorrhage]. / Kislotno-osnovnoe sostoianie i kislorodtransportnaia funktsiia krovi u bol'nykh v rannem periode posle operativnykh vmeshatel'stv po povodu iazvennogo gastroduodenal'nogo krovotecheniia.

Changes in the acid-base state and acid-transport function of blood were studied in 59 patients with gastroduodenal ulcer bleedings. More than 50% of the changes were more pronounced in patients with a deficient globular volume and its recovery was somewhat slower. In spite of reduced values of the concentration of hemoglobin in blood, 2,3-DPH and ATP of erythrocytes, most patients were found to have satisfactory compensation of the acid-transport function and balanced oxygen affinity for hemoglobin during the whole postoperative period.

[Blood coagulation in patients with ulcerous gastrointestinal hemorrhage]. / Sostoianie sistemy gemokoaguliatsii u bol'knykh s iazvennym zheludochno-kishechnym krovotecheniem.

In 108 patients with ulcerous gastrointestinal hemorrhage, the indices which characterize the coagulative and fibrinolytic systems of the blood were studied. At the moment of admission, in patients with severe blood loss, the moderate manifestations of the disseminated intravascular coagulation, which is the most characteristic in globular volume deficiency of more than 50%, were noted. After the operation, the revealed changes in the system of hemostasis increased. Beginning from the day 5, a tendency for normalization of the indices was noted, however by the moment of discharge of the patients they do not achieve the normal ones.

[Lipid peroxidation and lysosomal enzyme activity in patients with acute gastrointestinal hemorrhage of peptic ulcer etiology]. / Perekisnoe okislenie lipidov i aktivnost' lizosomal'nykh fermentov u bol'nykh s ostrym zheludochno-kishechnym krovotecheniem iazvennoi étiologii.

In examination of 51 patient with acute gastrointestinal bleeding of ulcer etiology, the activity of lysosomal enzymes, peroxide oxidation of lipids were increased, the activity of antioxidant system was decreased. This can lead to inhibition of proliferative processes, stipulating the severity of blood loss, course of the postoperative period, the incidence of postoperative complications, and lethality.

[Intensive therapy of patients surgically treated in acute gastrointestinal hemorrhage of peptic ulcer etiology]. / Intensivnaia terapiia bol'nykh, operirovannykh po povodu ostrogo zheludochno-kishechnogo krovotecheniia iazvennoi étiologii.

The emergency operations were performed in 6,506 patients for acute hemorrhage in gastric and duodenal ulcer. A method for the complex corrigative intensive therapy is presented. The use of combined parenteral and enteral nutrition facilitates a care of the patients, favours the prophylaxis of complications. Because of incomplete rehabilitation by the moment of patient's discharge from the hospital, it is necessary to continue the corrigative therapy directed at liquidation of the globular volume deficiency, correction of disproteinemia, normalization of the indices of central hemodynamics and metabolic processes in the organs and tissues.

[Organ-sparing operations in bleeding ulcers of the pylorus and duodenum]. / Organosokhraniaiushchie operatsii pri krovotochashchikh iazvakh privratnika i dvenadtsatiperstnoi kishki.

The organ-preserving operations were performed in 387, gastric resection--in 142, closure or excision of an ulcer without vagotomy--in 132 patients with bleeding pyloroduodenal ulcers. The lethality after gastric resection was 11.3%: after the emergency operations--16.3%; after early elective interventions--9.1%; after the organ-preserving operations--2.6, 5.3, 0.85%, respectively.

[Ways of improving the results in treating patients with acute gastrointestinal hemorrhage of peptic ulcer etiology]. / Puti uluchsheniia rezu'ltatov lecheniia bo'lnykh s ostrym zheludochno-kishechnym krovotecheniem iazvennoi étiologii.

The results of treatment of 1837 patients with gastric and duodenal ulcers, complicated by bleeding are presented. Emergency surgical interventions were performed in 468 patients, 92 (19.7%) died, early elective operations--in 416 patients, 13 (3.1%) died, conservative treatment was performed in 953 patients, 55 (5.8%) died. In 1274 patients, the actively expectant tactics was used, in 563--surgical tactics based on endoscopic characteristics of the source of bleeding and degree of the severity of blood loss. The use of this tactics permitted to reduce lethality after emergency operations from 27.7 to 9.6%, in patients treated conservatively--from 7.5 to 0.8%, to increase operative activity from 44.6 to 56.1%.