[Recurrence of acute gastroduodenal ulcer bleedings].
Multifactor analysis of 818 cases of acute gastroduodenal ulcer bleedings (clinical and laboratory examination, gastroscopy, morphological studies) was carried out, 97 of these patients had recurrence of bleeding. It is demonstrated that recurrence of gastroduodenal ulcer bleeding is cause by progressed ischemic necrosis in periulcerous zone in condition of local hypoperfusion as a result of systemic hemodynamic disorders due to acute blood loss syndrome and chronic ischemia dueto ulcerous process. Systemic hemostatic therapy, antisecretory drugs, methods of endoscopic hemostasis don't guarantee absence of bleeding recurrence. Prognosis of the recurrence must be based on assessment of significant clinical and gastroscopic data. Dynamical determination of pO2 in periulcerous zone is an additional prognostic criterion. Recurrence of gastroduodenal ulcer bleeding increases general and postoperative lethality 2 times as minimum. Active surgical policy based on prognosis of bleeding recurrence probability permitted us to reduce total lethality in acute gastroduodenal ulcer bleedings to 6.2%, postoperative lethality to 8.5%.
Gostishchev
V K
VK
Evseev
M A
MA
D000208:Acute Disease; D000368:Aged; D006439:Hemodynamics; D006706:Homeostasis; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis; D010437:Peptic Ulcer / Q000473:pathology* / Q000503:physiopathology*; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery*; D011336:Probability; D011379:Prognosis; D012008:Recurrence; D015427:Reperfusion Injury / Q000503:physiopathology