Endoscopic hemostasis of erosive-ulcerous gastroduodenal bleeding with fibrin glue at critically ill patients

摘要

Experience of endoscopic hemostasis of acute erosive-ulcerous gastroduodenal bleeding with fibrin glue at critically ill patients is described. This glue is adhesive substance based on high-concentrated solution of fibrinogen (concentration of protein not less 60 g/l). Application of adhesive permitted to stop the bleeding at 84 of 87 extremely seriously ill patients (mean point according to APACHE--II scale was 19.5+/-0.9). Prolonged endoscopic control with repeated application of adhesive permitted to avoid bleeding clinical recurrences, to stop repeatedly with endoscopy 4 of 6 recurrent bleedings, to avoid forced surgery at 80 of these patients. Adhesive accelerated significantly the healing of ulcers despite of hypoxic injury of mucosa. Endoscopic hemostasis permitted to avoid forced surgical aggression, to improve treatment results and to decrease lethality at critically ill patients.