Clinical and Morphological Basis of the Vacuum-Therapy Using in Complex Treatment of Patients with Gastroduodenal Ulcer Complicated by Bleeding

Abstract


The purpose of the study To evaluate the effectiveness of the low-dose vacuum in treatment of gastro duodenal ulcer complicated by bleeding. Materials and methods A comparative analysis of treatment of 82 patients with gastro duodenal ulcer. The first group included 46 patients which were treated by H2 -receptor blocks, proton pump inhibitors and antihelicobacter eradication after the final hemostasis. The second group consisted of 36 patients who have a range of treatment was part of a vacuum therapy on the original author's methodology. There were no significantly differences in two groups. For objectification an ulcer healing used a clinical parameters, endoscopy visualization, cytological and histological research. In statistical processing used Pearson's criterion χ2 and Fisher's criterion φ*. For the numerical measure of objective chance events considered the probability 95% (p<0.05). Results and their discussion During the first week of using the vacuum therapy the ulcer was cleaned; the granulator tissue, epithelization and scarring developed. After the short-time increasing of intraepithelial neutrophils number their number in the lamina propria increased on twice (φ* p=0.366). On the 21st day in one of three observations was a compete healing of the ulcer (φ* p=0.366), in other cases visualized active epithelialization and scarring. In cytograms the number of neutrophils decreased on 1.8 times (χ2 =1.073; df=1; p=0.300), in the histogram they achieved a minimum (φ* p=0.074), and in the lamina propria (φ* p=0.241). The number of lymphocytes in the lamina propria was increased to 54.0±20.2 (χ2 =1.441; df=1; p=0.230), correlating with an increase in mitotic activity of epithelium (φ* p=1.000). Conclusion Vacuum therapy, stimulating the regional blood circulation, stimulates the exacerbation of chronic inflammation in the ulcer. Then, with the extinction of "neutrophilic burst" of local inflammation is liquidated. The increase in "population" of the lamina propria lymphocytes is associated with potentiation of their morphogenetic function, which is consistent with increased mitotic activity of the epithelium and confirms the stimulation of reparation in the area of ulcers with help a low vacuum.

Yaroslavl State Medical Academy, Yaroslavl, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
MD, Professor, Head of department of general surgery of Yaroslavl State Medi-cal Academy

Yaroslavl State Medical Academy, Yaroslavl, Russian Federation

Email: author@vestnik-surgery.com
PhD, Associate Professor of the department of pathological anatomy of Yaroslavl State Medi-cal Academy

Yaroslavl State Medical Academy, Yaroslavl, Russian Federation

Email: author@vestnik-surgery.com
Aspirant of department of general surgery of Yaroslavl State Medi-cal Academy.

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