AbstractDespite the advances in endoscopic haemostasis, the incidence of recurrent ulcer bleeding remains to be high. It necessitates further search for its prognosis and methods of treatment.The objective of the research was to analyse risk factors for recurrent gastroduodenal ulcer bleeding.Materials and methods. The study included 203 patients with gastroduodenal ulcer bleeding. There were 135 (66.5%) males and 68 (33.3%) females. All the patients were examined and received conservative treatment according to treatment protocols.Results. Duodenal ulcer was diagnosed in 127 (62.3%) patients, gastric ulcer was found in 68 (33.3%) patients, gastroduodenal ulcer was seen in 9 (4.4%) patients. The recurrence of bleeding was observed in 24 (11.8%) cases. Most cases of recurrent bleeding (n=11 (45.8%) occurred within 2-3 days after the admission. 9 (37.5%) patients developed the recurrence of bleeding later. The lowest number of recurrent bleeding occurred within the first day - 4 (16.7%) cases. The incidence of recurrent bleeding was higher in men rather than in women - 17 (70.8%). Recurrent bleeding was observed in 9 (64.29%) patients with blood type O; 4 (28.57%) patients with blood type A; 1 (7.14%) patient with blood type B; 1 (7.14%) patient with blood type AB. The majority of recurrences (n=15 (62.5%) occurred in patients without ulcer in anamnesis. There was found no clear connection between ulcer location and the rate of recurrent bleeding.Conclusions.The scales of predicting recurrent bleeding that are known today do not consider a number of important clinical and pathogenetic factors as a basis of recurrence.The improvement of the results of treating bleeding ulcers is possible only on the basis of the complex of factors determining the effectiveness of regeneration.
Kovalchuk LYa, Shepetko EM, Shaprinskiy VO, et al. Innovatsiini tekhnolohii khirurhichnoho likuvannia hostrykh shlunkovo-kyshkovykh krovotech. Kyiv: Phoenix; 2014. 421 p.
Muguruma N, Kitamura S, Kimura T, Miyamoto H, Takayama T. Endoscopic management of nonvariceal upper gastrointestinal bleeding: state of the art. Clin Endosc. 2015;48(2):96-101. http://dx.doi.org/10.5946/ce.2015.48.2.96
Bereznitskiy YaS, Boiko VV, Brusnicina MP, et al. Standarty orhanizatsii ta profesiino orientovani protokoly nadannia medychnoi dopomohy khvorym z nevidkladnoiu khirurhichnoiu patolohiieiu orhaniv zhyvota. Kyiv: Zdorovia Ukrainy; 2010. 470 p.
Shepetko EM, Efremov VV. Suchasna taktyka i bezposeredni rezultaty likuvannia hostrykh vyrazkovykh shlunkovo-kyshkovykh krovotech. Khirurhiia Ukrainy. 2013;4:29-36.
Maggio D, Barkun AN, Martel M, Elouali S, Gralnek IM. Predictors of early rebleeding after endoscopic therapy in patients with nonvariceal upper gastrointestinal bleeding secondary to high-risk lesions. Can J Gastroenterol. 2013;27(8):454-458. http://dx.doi.org/10.1155/2013/128760
Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet. 1974;2(7877):394-397. http://dx.doi.org/10.1016/S0140-6736(74)91770-X
Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper gastrointestinal haemorrhage. Lancet. 2000;356(9238):1318-1321. http://dx.doi.org/10.1016/S0140-6736(00)02816-6
Rockall TA, Logan RFA, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38(3):316-321. http://dx.doi.org/10.1136/gut.38.3.316
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.