The Use of Asepticob-A and Platelet-rich Plasma in Complex Endoscopic Teatment of Patients with Ulcer Gastroduodenal Bleeding

Abstract


Relevance. Gastroduodenal ulcer bleeding is one of the most complex problems of emergency abdominal surgery. An endoscopic hemostasis is a crucial importance during the treatment of patients with gastroduodenal bleeding. The using of biologically active draining sorbents in combination with local haemostatic drugs is a promising direction in the endoscopic hemostasis.
Objective. The aim of the investigation is to improve the results of treatment of patients with acute ulcerative gastroduodenal hemorrhages by application of biologically active draining of sorbent Asepticob-A in combination with platelet-rich plasma for endoscopic hemostasis as an important component of complex therapy.
Materials and methods. The study is based on the results of treatment of 112 patients with peptic ulcer bleeding. They were treated in the specialized city centre for the treatment of patients with gastrointestinal bleeding of Voronezh state hospital of emergency medical care №1. During the treatment of patients of the main group (n=57 persons) was used individual complex approach with the using of biologically active draining of sorbent of new generation – Asepticob-A and platelet-rich plasma in endoscopic treatment of bleeding complications of gastroduodenal ulcers. In the comparison group (n=55 persons) was used the well-known traditional methods of endoscopic hemostasis without the use of granular sorbents and platelet-rich plasma.
Results and discussion. The effectiveness of treatment of patients with ulcerative gastroduodenal bleeding was assessed according to the criteria of reliability of hemostasis, assessment of dynamics of reparative processes in ulcerous defects, the frequency of recurrence of bleeding on the background of treatment using endoscopic techniques, prevention, emergency operations and mortality rate. The methods of treatment of gastroduodenal bleeding with the combined use of biologically active draining sorbents and platelet-rich plasma for the reliability of endoscopic haemostasis, that was developed and introduced into clinical practice, reduces the number of emergency operations in 2.6 times, mainly due to the reduction of recurrent bleeding and, as a consequence, leads to lower postoperative mortality.
Conclusions. The use of biologically active draining of sorbent Asepticob-A and platelet-rich plasma in complex endoscopic treatment of patients with ulcerative gastroduodenal bleeding allows to reduce the frequency of recurrence of bleeding from 10.9% to 3.5% (3.1 times), to reduce the number of emergency surgical interventions at the height of bleeding from 9.1% to 3.5% (2.6 times), to reduce postoperative mortality from 5.45% to 1.75% (3.1 times) and reduce the duration of inpatient treatment from 9.0 to 6.0 days (p<0.05).


Evgeny Fedorovich Cherednikov

facult-surg.vsmuburdenko@yandex.ru
N. N. Burdenko Voronezh state medical University 
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036

MD, professor, head of department of faculty surgery

Sergey Viktorovich Barannikov

Author for correspondence.
svbarannikov@rambler.ru
N. N. Burdenko Voronezh state medical University 
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036

assistant of the department of faculty surgery

Alexander Anatolievich Anatolievich Glukhov

Glukhov-vrn@yandex.ru
N. N. Burdenko Voronezh state medical University 
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036

 MD, professor, head of chair of general surgery

Igor Nikolaevich Banin

facult-surg.vsmuburdenko@yandex.ru
Voronezh state hospital of emergency medical care №1
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036

PhD, head of Voronezh state hospital of emergency medical care №1

Yuri Valentinovich Mallev

ymaleev10@yandex.ru
N. N. Burdenko Voronezh state medical University 
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036

MD, associate Professor of the operative surgery chair
with topographic anatomy

Vadim Vladimirovich Adianov

facult-surg.vsmuburdenko@yandex.ru
Hospital Medical-sanitary unit of the Directorate of the Federal security service of the Russian Federation in the Voronezh region
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036

PhD, head of surgical Department of the hospital Medical-sanitary unit of the Directorate of the Federal security service of the Russian Federation in the Voronezh region

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