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Articolul urmator |
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SM ISO690:2012 GUŢU, Eugen. Operaţia de urgenţă în ulcerul hemoragic gastroduodenal VS risc operator . In: Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, 21-23 octombrie 2020, Chişinău. Chişinău: USMF, 2020, p. 411. |
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Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” 2020 | ||||||
Congresul "Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”" Chişinău, Moldova, 21-23 octombrie 2020 | ||||||
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Pag. 411-411 | ||||||
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Rezumat | ||||||
Background. Selection between surgery and continuation of conservative treatment is often challenging in patients with recently stopped ulcer bleeding. Decision is made on estimation of rebleeding (R) risk, individual for each patient. Objective of the study. Aim of the study was to compare results of urgent (U) and early elective (EE) surgery, and to determine their reliance by grade of patients’ operative risk. Material and Methods. The study is based on result analysis of 285 patients, underwent surgery for bleeding gastroduodenal ulcer. The influence of factors, which determine “operative risk” (age and comorbidity), on results of urgent (for R) and early elective (for prevention of R) procedures was assessed. Results. There are no significant differences of treatment results between U and EE surgery in “low operative risk” patients (less than 60 years and without concomitant illnesses). In contrast in patients with “high operative risk” (over 60 years and/or with concomitant pathology), U procedure was associated by increased rate of postoperative morbidity (71,8% vs 25,9%, p < 0,001) and mortality (29,4% vs 4,9%, p < 0,001), comparative with EE surgery. Conclusion. Risk of postoperative complications and death in patients under 60 years old and without comorbidity do not depend on type of surgery, therefore indications for EE surgery should be limited. In these patients in occurrence of R, repeated endoscopic hemostasis and insistent conservative treatment |
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Cuvinte-cheie gastroduodenal ulcer, bleeding, operative risk, surgery, ulcer gastroduodenal, hemoragie, risc operator, operație |
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Cerif XML Export
<?xml version='1.0' encoding='utf-8'?> <CERIF xmlns='urn:xmlns:org:eurocris:cerif-1.5-1' xsi:schemaLocation='urn:xmlns:org:eurocris:cerif-1.5-1 http://www.eurocris.org/Uploads/Web%20pages/CERIF-1.5/CERIF_1.5_1.xsd' xmlns:xsi='http://www.w3.org/2001/XMLSchema-instance' release='1.5' date='2012-10-07' sourceDatabase='Output Profile'> <cfResPubl> <cfResPublId>ibn-ResPubl-126116</cfResPublId> <cfResPublDate>2020</cfResPublDate> <cfStartPage>411</cfStartPage> <cfISBN></cfISBN> <cfURI>https://ibn.idsi.md/ro/vizualizare_articol/126116</cfURI> <cfTitle cfLangCode='RO' cfTrans='o'>Operaţia de urgenţă în ulcerul hemoragic gastroduodenal VS risc operator </cfTitle> <cfKeyw cfLangCode='RO' cfTrans='o'>gastroduodenal ulcer; bleeding; operative risk; surgery; ulcer gastroduodenal; hemoragie; risc operator; operație</cfKeyw> <cfAbstr cfLangCode='EN' cfTrans='o'><p>Background. Selection between surgery and continuation of conservative treatment is often challenging in patients with recently stopped ulcer bleeding. Decision is made on estimation of rebleeding (R) risk, individual for each patient. Objective of the study. Aim of the study was to compare results of urgent (U) and early elective (EE) surgery, and to determine their reliance by grade of patients’ operative risk. Material and Methods. The study is based on result analysis of 285 patients, underwent surgery for bleeding gastroduodenal ulcer. The influence of factors, which determine “operative risk” (age and comorbidity), on results of urgent (for R) and early elective (for prevention of R) procedures was assessed. Results. There are no significant differences of treatment results between U and EE surgery in “low operative risk” patients (less than 60 years and without concomitant illnesses). In contrast in patients with “high operative risk” (over 60 years and/or with concomitant pathology), U procedure was associated by increased rate of postoperative morbidity (71,8% vs 25,9%, p < 0,001) and mortality (29,4% vs 4,9%, p < 0,001), comparative with EE surgery. Conclusion. Risk of postoperative complications and death in patients under 60 years old and without comorbidity do not depend on type of surgery, therefore indications for EE surgery should be limited. In these patients in occurrence of R, repeated endoscopic hemostasis and insistent conservative treatment</p></cfAbstr> <cfAbstr cfLangCode='RO' cfTrans='o'><p>Introducere. Decizia în favoarea tratamentului operator sau a continuării medicaţiei conservatoare la bolnavii cu hemoragie ulceroasă stopată este dificilă şi se ia în baza aprecierii riscului recidivei hemoragiei (RH) individual pentru fiecare pacient. Scopul lucrării. Evaluarea comparativă a rezultatelor operaţiilor de urgenţă imediată (UI) şi de urgenţă amânată (UA) şi influenţa asupra lor a gradului de risc operator al pacienţilor. Material și Metode. Studiul este bazat pe analiza rezultatelor tratamentului chirurgical de urgenţă a 285 de bolnavi cu hemoragie ulceroasă gastroduodenală. S-a analizat influenţa factorilor ce determină gradul de „risc operator” (vârsta şi patologia concomitentă) asupra rezultatelor intervenţiei de UI (efectuată pentru RH) şi de UA (pentru prevenirea acesteia). Rezultate. Nu s-au depistat diferenţe semnificative în rezultatele operaţiilor de UI şi de UA în lotul bolnavilor cu „risc operator redus” (sub 60 de ani, fără maladii concomitente). Viceversa, la pacienţii cu „risc operator înalt” (cu vârsta peste 60 de ani şi/sau patologie concomitentă) operaţia de UI este însoţită cu o rată mai înaltă de complicaţii postoperatorii (71,8% vs 25,9%, p < 0,001) şi letalitate (29,4% vs 4,9%, p < 0,001) decât operaţia de UA. Concluzii. Riscul complicaţiilor postoperatorii şi a decesului la bolnavii sub 60 de ani, fără patologie concomitentă nu depinde de tipul intervenţiei chirurgicale, de aceea indicaţiile pentru operaţie de UA necesită a fi limitate. 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