[Therapeutic and diagnostic tactics in complication of ulcer disease in elderly and aged].
In 78% of cases the ulcerative disease in elderly age proceeds with complications and presents a serious surgical problem. The specificity of elderly patients is the combination of several pathologies, on background of which the ulcerative disease proceeds. The level of an expressiveness of accompanying pathology influences on the prognosis of disease course and on the choice of medical tactics. Therefore for objectivization of state heaviness of the patient group mark systems of an estimation MODS and APACHE III are used. The interventions in gastroduodenal bleedings for the patients of elderly age should be differentiated and depended on a risk degree of bleeding relapse and adequate estimation of MODS heaviness. In 55.4% of the elderly patients the ulcerative perforation occur without antecedent history. Therefore indications to sewing of ulcers, including little-invasive interventions, should be extended in this group of the patients. The size of radical surgical interventions in absence of manifestation of the polyorganic insufficiency for the elderly patients should be the same, as for the younger patients.
Stupin
V A
VA
Russian State Medical University, Faculty of Gastric Surgery No. 1, Moscow.
Bel'kov
A V
AV
Smirnova
G O
GO
Narezkin
D V
DV
Siluianov
S V
SV
Kan
V I
VI
D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000601:surgery / Q000628:therapy; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D013276:Stomach Ulcer / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*