Trofimov M. Experimental-clinical grounds for the treatment method chоice of patients with ulcerous hemorrhage from upper parts of the digestive tract

The dissertation is devoted to the issue of treating patients with gastro-intestinal hemorrhage of ulcerous genesis. According to the data of examination of 2755 patients a complex analysis of clinical, endoscopic, morphological, microbiological and immunological indices has been carried out. Immunohistochemical examination of inducible NO-synthase in periulcerous area, G-cells of mucous in antral area of a stomach, spectrum-fluorine metric examination in rates of dynamics in stable metabolites of nitric oxide, serotonin, catecholamines and their metabolic predecessors in blood serum at different variants of disease course with application of modern methods have been studied. Experimental modeling of acute and chronic hemorrhaging ulcers with determination of inducible NO-synthase of mucous, submucous vascular and nervous nodes, dynamics of levels of stable metabolites and serum nitrogen in blood have been carried out. The performed examinations enabled to define the leading factors which cause the development of recurrent hemorrhage, new pathogeneticaly grounded methods of endoscopic homeostasis have been developed; prevention of recurring hemorrhage, new methodology for operative treatment of hemorrhaging duodenal ulcer by means of exteriorization have been developed.