«Саратовский научно-медицинский журнал» » Архив номеров » Volume 10, issue 3 » Публикация

Аннотация The research goal is evaluation of influence of changes in diagnostic & treatment possibilities and surgical approach on the results of treatment of patients with ulcerative gastro-duodenal bleedings (GDB). Material and methods: An analysis of the treatment results of 1885 patients suffering from ulcerative GDB, which have been treated in the surgery department of the "State clinical hospital No.6" in Saratov has been done. The information about the patients suffering from GDB has been retrieved from the digital archives, which were filed from 1991 to 2009. The patients have been divided into five groups according to five periods of work, each one differ by its own diagnostic & treatment possibilities and approaches. The evaluation was based the amount of operations, the number of different types of operations, the efficiency of endohemostasis, the amount of bleeding relapses and the lethality. Results: The introduction of computer prognosis for bleeding relapse, the increase in the number of endoscopic hemostatic methods, the application of Laser Doppler Flowmetry (LDF) for the evaluation of reliability of hemostasis, the use of dynamic endoscopy and testing probe for bleeding relapse in the state of prerelapse syndrome with the combination of preventive measures on the source of bleeding and antisecretory therapy have led to the decrease of overall lethality from 6,5% to 1,9%, and the postoperative lethality from 9,1% to 1,7%. Conclusion: The analysis of treatment results by periods made it possible to have an overview on different factors as they undergo changes during these periods, evaluate weak points in the current treatment tactic and set a direction for further investigations.