RESUMO
Basic principles of infusion-transfusional therapy, methods of endoscopic hemostasis as well as indications for surgical treatment of acute hemorrhagic ulcers of the stomach and the duodenum are presented. If is stated that valid use of endoscopic methods of hemostasis provides possibility for temporal hemostasis in 70% of patients. It endoscopic hemostasis is ineffective in hemorrhage from ulcer or in recurrent hemorrhage it is recommended to perform urgent surgical interventions. To avoid the relapse of hemorrhage after endoscopic hemostasis from ulcer or revealing endoscopic symptoms of unreliable (unstable) hemostasis it is necessary to perform delayed operations (not later that 2 days from the moment of admission of the patients). If the hemostasis shows to be stable which is proved by endoscopy, early elective operations (in 12-14 days) are indicated.
Assuntos
Úlcera Duodenal/complicações , Hemostase Endoscópica , Hemostasia Cirúrgica , Úlcera Péptica Hemorrágica/terapia , Substitutos do Plasma/administração & dosagem , Úlcera Gástrica/complicações , Doença Aguda , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/etiologia , Substitutos do Plasma/uso terapêutico , Recidiva , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Results of surgical treatment of 271 patients with malady recurrence after perforative gastroduodenal ulcer closure were adduced. Resectional methods of treatment were conducted in 118 patients, vagotomy combined with the stomach draining procedure--in 106, in combination with ulcer extraduodenization and duodenoplasty--in 47. Conduction of organpreserving operation with ulcer extraduodenization and duodenoplasty must be supposed mostly rational.
