内镜在改善胃十二指肠出血治疗效果中的可能性和地位

M. P. Korolev, R. G. Avanesyan, L. E. Fedotov, B. L. Fedotov, M. V. Antipova, L. Z. Khafizov
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引用次数: 0

摘要

在俄罗斯联邦,胃十二指肠出血的治疗结果还有很多需要改进的地方。根据俄罗斯联邦首席外科医生和内窥镜医师A. Sh. Ramishvili院士[2]的研究,治疗胃十二指肠出血的手术死亡率为19%,只有32%的病例在内窥镜下止血。文章分析了胃十二指肠出血治疗中应注意的问题。主要的问题是组织上的。外科医生和内镜医师严格执行国家临床建议,对胃十二指肠出血患者进行高质量的护理是必要的(1)。医院应创造特殊条件,帮助胃十二指肠出血患者。这些条件包括外科团队、重症监护病房、输血科或输血柜、配备现代数字内窥镜的24小时内窥镜(科或柜)以及所有止血工具。有必要治疗的不是出血本身,而是出血的病人。为此,有必要在内镜治疗后使用药物抗分泌治疗。外科医生和内窥镜医生同样了解胃十二指肠出血治疗问题的复杂性是非常重要的。
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Possibilities and place of endoscopy in improving the results of treatment of gastroduodenal bleedings
The results of treatment of gastroduodenal bleedings in the Russian Federation leave much to be desired. According to the chief surgeon and endoscopist of the Russian Federation, Academician A. Sh. Ramishvili [2], operative mortality in the treatment of gastroduodenal bleedings is 19 %, and only in 32 % of cases, bleeding was stopped endoscopically. The article analyzes the problems in the treatment of gastroduodenal bleedings. The main problem is organizational. Strict implementation of national clinical recommendations by surgeons and endoscopists is necessary for high-quality care for patients with gastroduodenal bleedings (1). Special conditions should be created in hospitals to help patients with gastroduodenal bleedings. These are the presence of a surgical team, intensive care unit, blood transfusion department or cabinet, 24-hour endoscopy (department or cabinet) equipped with modern digital endoscopes and all the tools to stop bleedings. It is necessary to treat not the bleeding but the patient with bleeding. For this purpose, it is necessary to use drug antisecretory therapy after endoscopic treatment. It is very important that surgeons and endoscopists equally understand the complexity of the problem – the treatment of gastroduodenal bleedings.
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CiteScore
0.30
自引率
0.00%
发文量
40
审稿时长
8 weeks
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