Zharikov S. Justification of treatment in patients with acute ulcerative gastroduodenal bleeding

The thesis is devoted to investigation of effectiveness of methods of endoscopic hemostasis, drug therapy, prevention of recurrence of bleeding and selection of method of surgical treatment in patients with acute ulcerative gastroduodenal bleeding, improvement of endoscopic hemostasis algorithm, antisecretory drug therapy, the study of morphological changes due to the use of drug therapy and prevention of recurrence of bleeding, as well as the development of models predicting recurrence of bleeding, death and operative treatment based on clinical and endoscopic data. The results of examination and treatment of 1,770 patients with acute ulcerative gastroduodenal bleeding are the material of the thesis. Developed treatment has allowed to reduce the recurrence of bleeding when conservative therapy from 13% to 5.6% and mortality from 24.3% to 13.3%; to reduce mortality in patients operated due to recurrence of bleeding from 18.5% to 9.1%. Postoperative mortality in patients operated in connection with non-reliable hemostasis has decreased from 4.2% to 2.8%. Analysis of received data showed that the developed surgical method reduced the overall postoperative mortality in the main group from 8.5% to 4.4%. Reduction of terms of treatment in the ICU from 32 ± 6 hours to 26 ± 3 hours is noted.