Сравнительный анализ эффективности физико-химических способов эндоскопического гемостаза при кровотечении из гастродуоденальных язв.

Представлен клинический анализ результатов использования современных методов эндоскопического гемостаза (инъекционный метод, аргоноплазменная коагуляция, радиоволновой гемостаз) при кровотечении из гастродуоденальных язв. Дана характеристика каждого метода. Показано, что эффективность гемостаза аргоноплазменной коагуляцией достигает 97,3%, радиоволновой коагуляцией - 95%, а инъекционным методом - не превышает 79,7%.

Comparative Analysis of the Efficacy of Physicochemical Methods of Endoscopic Hemostasis for Gastroduodenal Ulcer Bleeding

Peptic gastroduodenal ulcer bleeding (PGDUB) remains one of the most actual problems of urgent surgery despite the improvements in diagnosis and treatment. The main cause of failures in PGDUB treatment is early rebleeding. "Desperate operations" performed in rebleeding are associated with extremely high lethality. The work is based on the results of treatment of 557 patients with peptic gastroduodenal ulcer hemorrhage. 402 patients underwent endoscopic hemostasis for the purpose of arresting bleeding (125 cases) or prophylaxis (277 cases). Endoscopic hemostasis was not performed in 147 patients. Injection method was used in 240 patients for active hemorrhage (Forrest I, 69 (28.75%) cases) or for prophylaxis of rebleeding (Forrest II, 171 (71.25%) cases). Argon plasma coagulation was performed in 106 patients for acute (38 (35.84%) cases) or for spontaneously stopped (68 (64.15%) cases) ulcer bleeding. Radiofrequency hemostasis was applied in 56 patients. In active bleeding radiocoagulation was performed in 18 (32.1%) cases, in spontaneously stopped - in 38 (67.85%) cases. Rebleeding was observed in 39 (16.25%) cases after injection hemostasis, in 13 (12.2%) cases after argon plasma coagulation, and in 5 (8.9%) cases after radiocoagulation. Efficacy of argon plasma coagulation was found to be 97.3%, radiofrequency coagulation - 95%, and injection method - 79.7%.