GASTRODUODENAL BLEEDING IN PATIENTS WITH CARDIAC PATHOLOGY


Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Erosive and ulcerative gastroduodenal bleeding (GDB) in patients with cardiac pathology is threatening complication, in which the mortality rate ranges from 9,6 to 80%, reaching the highest numbers of patients of elderly and senile age. The need for acceptance of pathogenetic therapy, including antiplatelet agents, nonsteroidal anti-inflammatory drugs and anticoagulants of direct action greatly complicates the treatment of erosive and ulcerative GDB, which in itself is also a threat to the life of the patient. All this dictates the need for a rational treatment strategies for these patients to minimize the threat of the death of the patients from both the GDB and from heart disease. Designed by the authors of the algorithm treatment of different variants of the GDB allowed to reduce the mortality rate to 16,2%. Treatment of patients with this comorbidity requires a differentiated approach, depending on the nature and intensity of bleeding or the threat of its recurrence in the background of the need for pathogenetic therapy of the underlying disease.

Texto integral

Acesso é fechado

Sobre autores

Lyubov TVERITNEVA

N.V. Sklifosovsky Research Institute of Emergency Care

Email: tverlubov@yandex.ru
MD, Leading Research Fellow of Department of Emergency Surgical Gastroenterology

Irina KUZMINA

N.V. Sklifosovsky Research Institute of Emergency Care

PhD, Head of Research Emergency Department of Cardiology for Patients with Myocardial Infarction

Yelena KLYCHNIKOVA

N.V. Sklifosovsky Research Institute of Emergency Care

PhD, Head of Scientific Clinical and Biochemical Laboratory of Emergency Methods of Investigation

Andrey MIRONOV

N.V. Sklifosovsky Research Institute of Emergency Care

PhD, Head of Scientific Emergency Department of Endoscopy

Yuri TETERIN

N.V. Sklifosovsky Research Institute of Emergency Care

PhD, physician of Emergency Department of Endoscopy

Bibliografia

  1. Yusuf S., Zhao F., Mehta S.R., Chrolavicius S., Tognoni G., Fox K.K. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N. Engl. J. Med. 2001;345:494-502.
  2. Farrel B., Godwin J., Richards S., Warlow C. The Unated Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J. Neurol. Neurosurg. Psychiatry. 1991;54:1044-54.
  3. Ареф Абдулваса Н.А. Профилактика и лечение острых эрозивно-язвенных поражений желудка и 12-перстной кишки. Дисс.. канд. мед. наук. М., 2005:158 с
  4. Бокерия Л.А., Ярустовский М.Б., Шипова Е.А. Острые гастродуоденальные кровотечения в сердечно-сосудистой хирургии. М., 2004. 186 с.
  5. Восканян Э.Х., Купцов Н.Х., Шарков П.Н. Опыт лечения гастродуоденальных кровотечений у больных после операций на сердце и магистральных сосудах. Актуальные проблемы неотложной хирургии. Пятигорск, 2005. С. 214-5
  6. Султанаева З.В. Комплексное лечение эрозивно-язвенных поражений желудка и 12-перстной кишки у кардиохирургических больных. Дисс. ... канд. мед. наук. Уфа, 2007. 135 с
  7. Нурманова М.Ж. Диагностическая и лечебная эндоскопия при гастродуоденальных кровотечениях после операций на сердце и аорте. Дисс. ... канд. мед. наук. М., 2004. 138 с
  8. Halm M.A. Acute gastrointestinal complication after cardiac surgery (review). Am. J. Crit. Care. 1996;5(2):109-18.
  9. Савичевский М.С., Бадаев Ф.И. Острые язвы желудочно-кишечного тракта после операций на сердце. Хирургия. 1983;12:92-3.
  10. Щеголев А.А. Лосек (омепразол) в экстренной хирургической гастро-энтерологии. Пособие для врачей под ред. проф. А.А. Щеголева. М., 2005. C. 19-20
  11. Hernandez-Diaz S., Garcia Rodriguez L.A. Cardioprotective aspirin users and their excess risk of upper gastrointestinal complications. BMC Med. 2006;4:22.
  12. Taha A.S., Angerson W.J., Knill-Jones R.P., Blatchford O. Upper gastrointes-tinal haemorrhage associated with low dose aspirin and antithrombotic drugs - a 6-year analysis and comparison with nonsteroidal anti-inflammatory drugs. Aliment. Pharmacol. Ther. 2005;22:285-9.
  13. Andreotti F., Testa L., Biondi-Zoccai G.G., Crea F. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25,307 patients. Eur. Heart J. 2006;27:519-26.
  14. Каминный А.И. Терапия антиагрегантами и нестероидными противовоспалительными препаратами. Соотношение риска и пользы. Лечащий врач. 2009;7:1-7.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar

Declaração de direitos autorais © Bionika Media, 2016

Este site utiliza cookies

Ao continuar usando nosso site, você concorda com o procedimento de cookies que mantêm o site funcionando normalmente.

Informação sobre cookies