RESUMO
The work presents an analysis of treatment 745 patients with gastrointestinal bleeding from acute ulcers. Algorithm diagnosis and treatment of acute ulcers by different groups of patients. Treatment depends on the nature of secretory activity stomach bleeding risk of relapse and localization ulcers.
Assuntos
Úlcera Duodenal , Hemorragia Gastrointestinal , Úlcera Gástrica , Doença Aguda , Adulto , Idoso , Algoritmos , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/etiologia , Úlcera Duodenal/prevenção & controle , Endoscopia Gastrointestinal , Suco Gástrico/química , Suco Gástrico/metabolismo , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/prevenção & controle , Antagonistas dos Receptores H2 da Histamina/administração & dosagem , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Humanos , Pessoa de Meia-Idade , Inibidores da Bomba de Prótons/administração & dosagem , Inibidores da Bomba de Prótons/uso terapêutico , Prevenção Secundária , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/etiologia , Úlcera Gástrica/prevenção & controleRESUMO
Use of mark systems estimation MODS and APACHE II at patients of elderly and senile age with the complicated forms of a stomach ulcer allows objectively to judge weight of a condition of the patient risk of operative treatment and to estimate the probable forecast of disease and mortality.
Assuntos
APACHE , Cuidados Críticos/métodos , Úlcera Duodenal/diagnóstico , Insuficiência de Múltiplos Órgãos/diagnóstico , Úlcera Gástrica/diagnóstico , Idoso , Úlcera Duodenal/complicações , Úlcera Duodenal/mortalidade , Úlcera Duodenal/terapia , Feminino , Humanos , Masculino , Insuficiência de Múltiplos Órgãos/complicações , Insuficiência de Múltiplos Órgãos/mortalidade , Insuficiência de Múltiplos Órgãos/terapia , Valor Preditivo dos Testes , Prognóstico , Risco , Úlcera Gástrica/complicações , Úlcera Gástrica/mortalidade , Úlcera Gástrica/terapiaRESUMO
At the present stage the number of operations is reduced at a ulcer gastroenteric bleeding. Occurrence modern antysecretor drags and wide introduction endoscopic and endovascular methods of hemostasis has led to decrease of urgent operative interventions in group of patients with high risk of rebleeding in 4 times. The number of such minimal operations was reduced in 10 times. They do not give expected hemostasis effect and are accompanied high mortality. Change of surgical tactics at elderly patients has led to decrease postoperative mortality from 15.8 up to 5.8% and the general mortality from 15.8 up to 9.6%.
Assuntos
Endoscopia Gastrointestinal/métodos , Úlcera Péptica Hemorrágica/cirurgia , Fatores Etários , Idoso , Humanos , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/tratamento farmacológico , Úlcera Péptica Hemorrágica/mortalidade , Complicações Pós-Operatórias/mortalidade , Fatores de Risco , Prevenção Secundária , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The results of treatment of 85 patients with trophic ulcers of various origin by leukocytic serum were compared with the results of treatment of 46 patients treated by routine method. The best clinical and aesthetic effect of this treatment was revealed in a group of patients with trophic ulcers due to vein varicosity. From 58 patients epithelization was detected in 49 (84,5%). The relapses of trophic ulcers in a period from 6 months to 1,5 years were revealed in 5 patients. The use of leukocytic serum ensures high percent of closure of the ulcers chiefly of venous etiology.
Assuntos
Úlcera da Perna/terapia , Leucócitos , Cicatrização , Adulto , Idoso , Feminino , Seguimentos , Humanos , Úlcera da Perna/etiologia , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A new method for the formation of an invagination areflux esophago-intestinal anastomosis is suggested. Incompetence of the anastomosis was not encountered in any of the 52 performed operations for gastrectomy. Five patients died, but the cause of death was not connected with the method of anastomosis formation.
Assuntos
Esôfago/cirurgia , Gastrectomia/métodos , Intestino Delgado/cirurgia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A new mode of forming an invaginational areflux esophagus-stomach-intestinal anastomosis was proposed. Seven patients were operated on by the proposed procedure. No cases of incompetence of anastomotic sutures were observed. The analysis of long-term outcomes suggests that there were no complications such as reflux-esophagitis and cicatricial strictures, which is accounted for by anatomical and surgical features of this mode of anastomosis.
Assuntos
Cárdia/cirurgia , Esôfago/cirurgia , Jejuno/cirurgia , Neoplasias Gástricas/cirurgia , Estômago/cirurgia , Idoso , Anastomose Cirúrgica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/diagnóstico , Fatores de Tempo , Resultado do TratamentoRESUMO
The article deals with the experience in surgical treatment of 157 patients with chronic venous insufficiency complicated by trophic ulcers of the leg. Purposeful study of the method of two-stage operative treatment of trophic ulcers of the lower extremities of venous origin was conducted. The expediency of dividing the operation into two stages is substantiated on basis of analysis of the results. One-stage operation was carried out in 77 and two-stage operation in 80 patients. In the group of patients treated by one-stage operation 7 (9.8%) had suppuration of the postoperative wounds. No suppuration of wounds was encountered in patients who were operated on in 2 stages. Among 51 patients who underwent one-stage operation 4, (7.8%) had a recurrence of the disease. A recurrence of the disease (trophic ulcer) was not revealed in 57 patients treated by two-stage operation.
