Choice of treatment method at acute gastroduodenal ulcerous bleedings.

摘要

Experience of treatment of 1307 patients with acute gastroduodenal ulcerous bleedings is analyzed. Three variants of treatment tactics are compared: expectant, active and differential. Differential tactics based on prediction of bleeding recurrence and assessment of patient's condition severity permit to improve the treatment results. Original clinical-endoscopic system of hemostasis stability assessment was used for prediction of bleeding recurrence, integral scale APACHE III - for assessment of patient's condition severity. Algorithm of treatment at acute gastroduodenal ulcerous bleedings is offered. Principles of differential treatment tactics have permitted to reduce overall lethality at acute gastroduodenal ulcerous bleedings to 3.2%, postoperative lethality - to 6.2%.