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SM ISO690:2012 BERLIBA, Sergiu, DOLGHII, Andrei, BESCHIERU, Eugeniu, GHEORGHIŢA, Vadim. Effectiveness of endoscopic hemostasis in controlling of bleeding from chronic gastric/duodenal ulcers. In: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 1, 20-22 octombrie 2021, Chişinău. Chișinău, Republica Moldova: 2021, p. 293. ISBN 978-9975-82-223-7 (PDF).. |
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Cercetarea în biomedicină și sănătate: calitate, excelență și performanță 2021 | ||||||
Conferința "Cercetarea în biomedicină și sănătate: calitate, excelență și performanță" 1, Chişinău, Moldova, 20-22 octombrie 2021 | ||||||
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Pag. 293-293 | ||||||
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Background. Upper gastrointestinal bleeding is a problem of emergency surgery and accounts for 70-80% of all gastrointestinal bleeding. The structure of hemorrhages has now changed, the mortality constitutes 10-15% and the endoscopic hemostasis (EH) has decreased the lethality by 2 times. Objective of the study. The purpose of this study was to evaluate the results of endoscopic hemostasis in combination with antisecretory therapy in controlling of bleeding from chronic gastroduodenal ulcers (G/D). Material and Methods. We have evaluated the results of the associated treatment in 60 patients with bleeding from chronic (G/D) ulcers, with a mean age of 43.5 ± 14.5 years. The bleeding was repeated in 18.7%. The ratio of G/D hemorrhage was 7/53, respectively. The severity of hemorrhage constituted 71.4% F I vs 66% F II. The methods of EH have been included injection, clipping or their association. Results. In 49 patients, primary the hemorrhage area was injected, and in 6 - clips were applied, the combination of both methods being performed in 8.3% of cases due to its inefficiency at the time of performing. The recurrence of hemorrhage has occurred in 3 (5%) patients with Forrest 1, the ulcers being located on the gastric body and posterior duodenal wall (the area with main vessels), morphologically being calloused ulcers. The number of recurrences was more frequent in patients with isolated hemostasis vs. the group with combined hemostasis, where recurrence was not recorded. The instability of repeated hemostasis in 7 patients was an indication for surgery with a postoperative mortality rate of 3.4%. Conclusion. The main factors that determine unstable endoscopic hemostasis are the morphology of the ulcer and the degree of hemorrhage, and the recurrence of hemorrhage is an indication for the combined method of endoscopic hemostasis with permanent cessation of bleeding. |
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Cuvinte-cheie Endoscopic hemostasis, chronic ulcer, recurrence of hemorrhage, hemostază endoscopică, ulcer cronic, recidiva hemoragiei |
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