Author/Editor		Skok, Pavel
Title		Vpliv endoskopske hemostaze na zmanjšanje umrljivosti pri bolnikih s krvavitvami iz prebavil
Translated title		Effect of endoscopic hemostasis on reduction of mortality in patients with hemorrhage from the digestive tract
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 35, št. 2
Publication year		1996
Volume		str. 249-56
Language		slo
Abstract		Endoscopy is the method of choice for localizing the site of hemorrhage and transendoscopic hemostatic procedures in patients with hemorrhage from the digestive tract. The aim of the study was to establish the mortality of patients with upper gastrointestinal bleeding and endoscopic hemostasis in our institution. The retrospective analysis includes patients who had undergone urgent endoscopic examination of the upper digestive tract and hemostatic interventions with sclerotherapy, laser photocoagulation or electrocoagulation of the hemorrhaging spot in the period between january 1994 and may 1995. 1000 patients were examined, 638 male and 362 female. In only 312 patients (31,2%) the examination revealed signs of acute or recently hemorrhage. Hemostatic interventions were performed in 275 cases. During the hospitalisation on the internal depertment 14 patients died. In 9 patients (9/275,3%) with acute hemorrhage, endoscopic hemostsis did not prove successful, therefore after seveal unsuccessfully repeated endoscopic interventios (21 in all) the patients were treated operatively. During the postoperative period, 4 patients died because of complications. Despite the development of endoscopic instruments and methods of hemostasis, mortality due to to hemorrhage from the digestive tract has not decreased essentially. Namely, numerous demanding endoscopic procedures are carried out in older patients having other diseases beside the basic one. These diseases represent the risk factors for evental surgical treatment and the following complications.
Summary		Endoskopija je najučinkovitejša metoda za odkritje mesta krvavitve in transendoskopske hemostatične posege pri krvavitvah iz prebavil. Namen študije je ugotoviti umrljivost bolnikov, pri katerih smo izvršili endoskopsko hemostazo zaradi krvavitve iz zgornjih prebavil. Retrospektivna študija zajema bolnike, pri katerih smo od januarja 1994 do maja 1995 opravili urgentne endoskopske preiskave zgornjih prebavil in hemostatične posege s sklerozacijskim zdravljenje, elektrokoagulacijo ali lasersko fotokoagulacijo krvavečega mesta. Pregledali smo 1000 bolnikov: 638 moških in 362 žensk. Pri 312 bolnikih (31,2%) so bili ob preiskavi prisotni znaki akutne krvavitve ali sledovi pretekle krvavitve. Endoskopsko hemostazo smo izvršili pri 275 bolnikih. Med zdravljenjem na internem oddelku je umrlo 14 bolnikov. Pri 9 bolnikih (9/275, 3% z akutno krvavitvijo endoskopska hemostaza ni bila uspešna. Po neuspešnih, ponovljenih endoskopskih posegih (skupaj 21), smo jih operativno, kirurško zdravili. V pooperativem obdobju so 4 bolniki umrli zaradi zapletov. Kljub razvoju endoskopskih instrumentov in metod hemostaze se umrljivost zaradi krvavitve iz prebavil ni bistveno zmanjšala. Mnogo zahtevnih endoskopskih posegov opravimo pri starejših bolnikih, ki imajo pogosto tudi druge bolezni. Te predstavljajo dejavnike tveganja tudi za morebitno operativno, kirurško zdravljenje in zaplete po njem.
Descriptors		GASTROINTESTINAL HEMORRHAGE CHILD ADOLESCENCE ADULT MIDDLE AGE AGED HEMOSTASIS, ENDOSCOPIC ENDOSCOPY, GASTROINTESTINAL