A.I. Cherepanin, L.J. Timen, B.A. Hait, S.V. Stonogin : другие произведения.

Medical tactics for ill a peptic ulcer of stomach and duodenum with high risk of operative measure

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Medical tactics for ill a peptic ulcer of stomach and duodenum with high risk of operative measure.

A.I. Cherepanin, L.J. Timen, B.A. Hait, S.V. Stonogin

(Moscow medical academy of a name of I.M. Sechenov, stand of surgical illnesses N2 of 1-st medical faculty, urban hospital N20, Moscow, Russia).

   The purpose: demonstrating of features of medical tactics for ill with the complicated forms of peptic ulcer of stomach and duodenum having high scale of risk of operative measure.
   Problems: definition of role of tube methods in a complex of treatment of peptic ulcer of a stomach and duodenum and algorithm of Series treatment of patients with high risk of an operative measure.
   In default from an immediate surgery in connection with high risk of an operative measure for 67 ill with the complicated forms of peptic ulcer of stomach and duodenum (stenosis, bleeding, penetration) is compelled have used complex fissile medical-conservative tactics. At the first stage it included: 1) endoscopic hemostasis, primary and preventive (1-2 times per day) at threat of a ulcerative bleeding; 2) production during esophagogastroduodenoscopy of the capillary noseejunal probe with the purpose of disintoxication (paratube evacuation of gastrointestinal contents, lavage, of intestine cooled saline solutions) and liquidations of the motor - evacuation disturbance accompanying peptic ulcer of stomach and a duodenum; 3) parenteral and enteral correction of homeostasis through the capillary noseejunal probe; 4) antiulcerous therapy.
   The first stage lasted 5-7 days. At the second stage (7-14 days) have used the capillary noseejunal probe, peroral diet N1 and antiulcerous therapy. In case of a delayed reparation of ulcers at the third stage resorted to a medical endoscopy (7-10 days). In process of a decrease operationally - anesthetic risks 35 ill were operated. Application of Series treatment has allowed to lower an over-all mortality in 2,1, and operational - in 1,6 times.
  

Data about writers:

   1) Cherepanin Andrey Igorevich - the candidate of medical sciences, the senior lecturer of stand of surgical illnesses N2 of the Moscow medical academy of a name I.M. Sechenov
   Phone 471-11-35.
   2) Timen Leonid Jakovlevich - the lieutenant colonel of a medical service, the member of the American academy of medical sciences, the member of the American academy of sciences, the doctor of the maximum category of 20-th urban hospital
   Phone 471-33-62.
   3) Boris Abramovich Hait - the assistant of the chief medical officer on surgery of urban hospital N20 of Moscow.
  
   4) Stonogin Sergey Vasil'evich - the surgeon of zymotic body of the Tooshino children's municipal hospital of Moscow, the candidate of medical sciences.
   143400 Krasnogorsk, Zheleznodorozhnaja 28A 24.
   E-mail: main70@stk.mmtel.ru
   http://stonogin.narod.ru/sergeyvs.html
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