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Relevance. Improvement of medical and diagnostic care for ulcerative gastroduodenal bleeding is a complex problem of modern medicine, the solution of which is connected both with the search for modern medical technologies and introduction of ones into clinical practice, and with the necessity to conduct in-depth analysis of the effectiveness of medical care at various stages of its delivery in this pathology. Purpose. To study the dynamics of the main indicators of the provision of medical and diagnostic care to patients with ulcerative gastroduodenal bleeding in a large hospital for in-patients and to evaluate the long-term results of conservative treatment of this group of patients. Materials and methods. The data of the Voronezh regional clinical hospital for the period from 1989 to 2010 (during which 1831 patients were hospitalized) were taken to assess the dynamics of the main indicators of treatment and diagnostic care for ulcerative gastrointestinal bleeding. The long-term results of 106 patients were analyzed. Among the patients, males predominated (70.7%), the average age was 50.2 ± 4.7 years (median - 18 - 79 years). In 62 patients (58.5%) bleeding ulcer was located in the duodenum. Results. There was a general tendency to reduce the number of hospitalizations by 57.8% during the analyzed period. Frequency of surgery in this pathology was 56.0% in 1989-1993. This indicator decreased to 33.8% against the background of an increase in the postoperative mortality to 8.7% in the period from 2009 to 2013. Favorable outcomes of treatment were noted in 74.5% of patients. The development of various complications and recurrences of bleeding was noted in 17.9% of patients with peptic ulcer with predominant localization of ulcers in the duodenum. This gives grounds for recommending in the current situation the implementation of planned surgical interventions. Conclusions. Conservative treatment of ulcerative gastroduodenal bleedings with the use of endoscopic technologies creates conditions for optimization of immediate and long-term outcomes of treatment. The polyetiologic nature of the disease and the significant specific gravity of severe combined pathology makes it urgent to introduce a multidisciplinary brigade principle for the treatment of ulcerative gastroduodenal bleeding.

vestnik èksperimentalʹnoj i kliničeskoj hirurgii

Evaluation of the dynamics of the main indicators of treatment care and the long-term results of conservative treatment of ulcerative gastroduodenal bleeding