Lemko I. Prevention of early relapses of bleeding from bleeding duodenal ulcers.

The dissertation is devoted to the development of complex treatment methods for patients with bleeding duodenal ulcers. The frequency of early relapses of bleeding may be reduced through improvement the regimes of proton pomp inhibitors (PPI) use after endoscopic hemostasis. The analysis of the effectiveness of complex treatment of patients with active bleeding and stigmas of recent ulcerative duodenal bleeding was made. This treatment included minimal invasive endoscopic surgery (electric coagulation or endoscopic injective therapy combined with electric coagulation) and conservative treatment aimed to keep up the attained hemostasis. New schemes of PPI were approbated: in the dose of 40 mg/day intravenously in dropper or 40 mg twice a day intravenously in dropper for three days with subsequent its administration per os. It was proved that effectiveness of PPI use does not depend on the activity of bleeding. It was determined that administration of Omeprazole or Pantoprazole according to the elaborated scheme is an effective prophylactic method, which reduces the frequency of bleedings relapses up to 6.3% cases in comparison with 15.5% in the control group.