DOI: 10.25881/BPNMSC.2020.54.37.008

Authors

Povalyaev A.V.1, Duvanskij V.A.1, Chernekhovskaya N.E.2

1 O.K. Skobelkin State Research Center for Laser Medicine, Moscow

2 Russian Medical Academy of Continuing Professional Education, Moscow

Abstract

The aim of the study was to develop a program for the treatment and prevention of erosive and ulcerative bleeding in patients at risk through the use of combined endoscopic hemostasis, drug therapy and physical methods of treatment. Material and methods. 315 patients were examined and treated. The patients were divided into 3 groups: group 1 included 81 elderly and senile patients, group 2 — 138 patients who had undergone severe surgical interventions, group 3 — 96 patients with abdominal ischemic disease. During esophagogastroduodenoscopy, acute erosions and acute ulcers were detected in all patients, which were the source of bleeding. They were evaluated according to the criteria of J. A. Forrest. To stop the bleeding, an injection method was used (0.005% solution of epinephrine in a volume of 5–20 ml), argonoplasma coagulation using the coagulator ERBE and exogenous nitric oxide from the Plason device. Successful bleeding arrest occurred in 98.4% of patients. In all patients, epithelialization of acute erosions and ulcers occurred 2 times faster than in patients who did not include nitric oxide in complex therapy.

Keywords: erosion, acute ulcer, gastrointestinal bleeding, argonoplasma coagulation, NO-therapy, laser Doppler flowmetry, microcirculation.

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For citation

Povalyaev A.V., Duvanskij V.A., Chernekhovskaya N.E. Erosive and ulcerative gastrointestinal bleeding in patients at risk: clinic, diagnosis, treatment. Bulletin of Pirogov National Medical & Surgical Center. 2020;4(15):39-44. (In Russ.) https://doi.org/10.25881/BPNMSC.2020.54.37.008