Treatment policy for ulcerative gastroduodenal hemorrhages

The authors analyzed the results of treatment of 827 patients with chronic peptic ulcer hemorrhages. They studied the possibilities of various methods of endoscopic hemostasis of ulcerative gastroduodenal hemorrhages (UGDH). Diathermy proved to be the least effective method of hemostasis - in 59%. In case of irrigation of the source of bleeding hemostasis was achieved in 88,7% and in case of use of combined methods - 94,1%. Application of irrigation methods is expedient in case of diffuse ulcer hemorrhage (Forrest I B) while in case of stream hemorrhage (Forrest I A) combined hemostasis methods are preferable. It has been shown that the method of therapeutic endoscopy does not significantly affect the freguency of recurrent hemorrhages. The major element of the UGDH conservative treatable is antisecretory therapy. By their effectiveness the proton pump blockers are superior to H2-blockers; in case of their application the frequency of recurrent hemorrhages was 5 and 28,9%, respectively. The primary way to improve treatment results is forecasting of recurrent hemorrhages and preventive operations.