International Journal of Biomedicine.2020;10(2):129-132.
DOI: 10.21103/Article10(2)_OA8
Originally published June 15, 2020.
Background: The treatment of ulcerative gastroduodenal bleeding (GDB) remains one of the most acute problems in emergency surgery. The aim of our research was to improve the results of treatment of patients with bleeding gastroduodenal ulcers (GDUs) through the use of endoscopic pneumatic applications of platelet-rich auto-plasma (PRAP) and the cytoprotective sorbent Aseptisorb-A.
Methods and Results: The study included 112 patients with bleeding GDUs. All patients were divided, by random sampling, into two equivalent groups: the main group (MG, n=57) and the comparison group (CG, n=55). In the treatment of MG patients, an individual approach was applied that used Aseptisorb-A and biologically active hemostatic agent PRAP in the complex endoscopic treatment of GDU complicated by bleeding. In CG, traditional methods of endoscopic hemostasis (EH) were used without PRAP and granular sorbents. After that, complex treatment of patients in the MG and CG did not differ. The relapse rate and operational activity was 3.5% in the MG and 10.9% in the CG (P=0.04); mortality rate was 1.75% in the MG and 5.45% in the CG; the duration of inpatient treatment in the MG and the CG was noted within 6.0(5.0;7.0) and 9.0(8.0;10.0) days, respectively (P<0.01).
Conclusion: The developed method for treatment of ulcerative GDB with the combined use the cytoprotective sorbent Aseptisorb-A and a biologically active hemostatic agent PRAP, for the reliability of EH, reduces the number of emergency operations by 2.6 times, mainly due to a decrease in the number of rebleedings and, as a consequence, leads to a decrease in postoperative mortality by 3.1 times.
1. Budnevsky AV, Cherednikov ЕF, Popov AV, Ovsyannikov ES, Kravchenko AY, Kuranosov AY, Fursov KO. A complex, multidisciplinary approach to prevention of gastro-duodenal bleeding in therapeutic patients of a general hospital. International Journal of Biomedicine. 2017; 7(3):204-207.
2. Shapkin YG, Potahin SN. [The dynamics of main indicators for the treatment of ulcerative gastroduodenal bleeding - the analysis of several years studies]. Saratov Journal of Scientific Research. 2014;10(3):456-460. [Article in Russian].
3. Cherednikov ЕF, Barannikov SV, Romantsov MN, Popov AV. New aspects of preventive endoscopic hemostasis in the treatment of peptic ulcer bleeding in the experimental condition. The EPMA Journal. 2017;8(S1):45.
4. Adianov VV, Cherednikov EF. [Optimizing treatment of gastroduodenal bleeding in patients with high surgical risk]. System Analysis and Management in Biomedical Systems. 2014; 13(4): 841-846. [Article in Russian].
5. Cherednikov ЕF., Budnevsky AV, Popov AV, Fursov KO. A new opinion on gastroduodenal bleeding preventon in patients with somatic patology. The EPMA Journal. 2017; 8(S1): 46.
6. Budnevsky AV, Popov Art V, Cherednikov EF. [Erosive-ulcerative lesions of the stomach and duodenum in therapeutic patients: prevention of bleeding]. Nauchno-medicinskij vestnik Central'nogo CHernozem'ya. 2016;65:64-71. [Article in Russian].
7. Deryaeva OG, Cherednikov EF. [Multimodality therapy of erosiveulcer gastroduodenal bleeding by patients in a multidisciplinary hospital]. System Analysis and Management in Biomedical Systems. 2014; 13(3):725-730. [Article in Russian].
8. Cherednikov EF, Deryaeva OG, Cherednikov EE, Adianov VV, Bondarenko AA, Yakushev FK. [The effectiveness of the modern approach to the treatment of patients with gastroduodenal bleeding in a multidisciplinary hospital]. Nauchno-medicinskij vestnik Central'nogo CHernozem'ya. 2016;65:20-25. [Article in Russian].
9. Romantsov MN, Cherednikov EF, Glukhov AA, Fursov KO. New technologies of endoscopic hemostasis in the treatment protocol of patients with gastroduodenal ulcer bleeding. Journal of Experimental and Clinical Surgery. 2018; 11(1): 16-23. [Article in Russian].
10. Cherednikov ЕF, Barannikov SV, Maleev YuV, Fursov KO,. Litovkina TE, Zakurdaev EI, Ovsyannikov ES. Experimental justification of using Aseptisorb-A and platelet-rich plasma in endoscopic treatment of mold bleeding stomach defects. International journal of biomedicine. 2017;7(4):298-301.
11. Cherednikov EF, Barannikov SV, Fursov KO, Polubkova GV, Danilenko VI, Stepanov DS. [Healing of bleeding experimental defects of the stomach with topical anilovin and platelet-rich plasma]. Journal of Volgograd State Medical University. 2017; 2(62): 130-133. [Article in Russian].
12. Romantsov MN, Cherednikov E F, Danilenko VI, Stepanov DS, Fursov K O, Deryaeva AG. [Morphological Characteristics of Processes of Simulated Bleeding Gastric Defects Reparation in Treatment with Gelplastan and Diovin]. Journal of Anatomy and Histopathology. 2017; 6(1): 81-86. [Article in Russian].
13. Cherednikov EF, Kashurnikova MA, Romantsov MN, Barannikov SV, Bolkhovitinov A E, Gaponenkov DG, Lyubimov PYu. Experimental study of new means of local hemostasis in the treatment of gastric bleeding. Nauchno-medicinskij vestnik Central'nogo CHernozem'ya. 2016; 65: 27-33. [Article in Russian].
14. Cherednikov EF, Barannikov SV, Maleev YuV, Fursov KO, Litovkina T E, Zakurdaev EI. [Experimental justification of the use of biologically active draining sorbent and plasma enriched by thrombocytes in treatment of bleeding defects of the stomach]. Journal of New Medical Technologies. 2017;24(2):114-118. [Article in Russian].
15. Cherednikov EF, Batkaev AR, Baev VE. The Reparative regeneration of erosive-ulcerative lesions of the stomach and duodenum in the local treatment of hydrophilic granular sorbents. System Analysis and Management in Biomedical Systems. 2005; 4(2): 224-225. [Article in Russian].
16. Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet. 1974;2(7877):394-7.
Download Article
Received March 13, 2020.
Accepted April 4, 2020.
©2020 International Medical Research and Development Corporation.
