Leshchishin I. Complex treatment and prophylaxis of the acute erosive-ulcerous gastroduodenal bleeding among patients with myocardial infarction.

The considerable role of violations of venous microcirculation is shown in pathogenesis of defeats of overhead departments of gastroduodenal highway in patients with myocardial infarction was shown. The prophylaxis of the acute erosive-ulcerous gastroduodenal bleeding is offered at myocardial infarction by therapy of omeprazol in a dose 20 mg simultaneously with diosmin/hesperidin in a dose 450/50 mg each 12 hours from the first days from the beginning of disease during 10 days, which allowed to decrease frequency of their origin from 3.4 to 2.5%, stake of the active bleeding (Forrest I) from 24.0 to 14.9%, that specifies on the necessity of its conducting all patients with myocardial infarction. The algorithm of medical tactic is developed in case of occurring of the acute erosive-ulcerous gastroduodenal bleeding in patients with myocardial infarction and it is set that testimonies to surgical treatment of such patients it is been bleeding which proceeds at uneffectiveness of endoscopic haemostasis orrelapse of bleeding in patients with ejection fraction of left ventricle of greater 35%. For ejection fraction below 35% endovascular embolization of bleeding vessel is justified.Introduction of medical tactic algorithm developed by us at the exposure of signs of the acute erosive-ulcerous gastroduodenal bleeding of patients with myocardial infarction in complex with prophylactic measures allowed to reduce lethality in this group of patients from 17.0 to 11.9%, that for certain does not differ from lethality of patients myocardial infarction without this complication for relevant period (10.1%).