Author/Editor		Skok, Pavel
Title		Endoskopska hemostaza in farmakološko zdravljenje pri nevarikoznih krvavitvah iz zgodnje prebavne cevi
Type		članek
Source		Gastroenterolog
Vol. and No.		Letnik 11, št. 24-25
Publication year		2007
Volume		str. 46-55
Language		slo
Abstract		The technological development of endoscopic instruments and their accessories, especially in the last two decades, introduced several new diagnostic and therapeutic procedures in the digestive tract. Endoscopy has proved successful in hemostasis of bleeding sources in the gastrointestinal tract and in other interventional endoscopic procedures. In gastrointestinal haemorrhage, urgent endoscopy enables identification of the bleeding source, selection of most appropriate haemostatic method, risk assessment, and facilitates clinical decisions. Improvement of the gastrointestinal haemorrhage outcome was achieved also with modern pharmacologic treatment. The efficacy of several endoscopic haemostatic methods in nonvariceal upper gastrointestinal haemorrhages and principles of modern pharmacologic treatment are presented. The introduction of proton pump inhibitors was a significant advancement in treating bleeding peptic ulcer and erosive mucosal lesions of the digestive tube. Various factors affect the success of treatment in patients with digestive tract haemorrhage - besides endoscopic hemostatic procedures mainly modern pharmacologic and adequate supportive treatment in intensive care units.
Summary		Tehnološki razvoj endoskopskih instrumentov in pripomočkov je zlasti v zadnjih dveh desetletjih v gastroenterologiji omogočil vrsto novih diagnostičnih postopkov in nove načine zdravljenja. Endoskopija se je potrdila kot učinkovita pri hemostazi krvavečih virov v prebavni cevi in pri raznih drugih intervencijskih posegih v prebavilih. Nujna endoskopija omogoča natančno oceno vira krvavitve in ogroženosti bolnika, izbiro najprimernejše metode hemostaze ter olajša in usmerja klinične odločitve. Napredek v zdravljenju in izidu krvavitev je omogočilo tudi sodobno farmakološko zdravljenje. Prikazani so uspešnost endoskopske hemostaze pri nevarikoznih krvavitvah v zgornji prebavni cevi in sodobna načela farmakološkega zdravljenja. Zaviralci protonske črpalke pomenijo pomemben napredek pri zdravljenju krvaveče peptične razjede in hemoragičnoerozivnih sprememb sluznice prebavne cevi, ki so najpogostejši vzrok krvavitev. Endoskopski posegi pri bolnikih s krvavitvami v prebavilih in sodobno farmakološko zdravljenje ter ustrezno podporno zdravljenje v usmerjenih enotah intenzivne medicine zagotavljajo dober izid zdravljenja.
Descriptors		HEMOSTASIS, ENDOSCOPIC GASTROINTESTINAL HEMORRHAGE ENDOSCOPY