Author/Editor		Skok, Pavel
Title		Peptična razjeda - najpogostejši vzrok krvavitve iz prebavne cevi
Translated title		Peptic ulcer - the most frequent source of gastrointestinal hemorrhage
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 68, št. 7-8
Publication year		1999
Volume		str. 415-9
Language		slo
Abstract		Background. Peptic ulcer hemorrhage is the most frequent source of gastrointestinal bleeding. The aim of the present study was to investigate the frequency of peptic ulcer bleeding in a 3-year period and to evaluate the risk factors in this type of bleeding. Patients and methods. The prospective study includes patients with peptic ulcer hemorrhage in which interventional endoscopy of the upper digestive tract was carried out between 1 January 1994 and 31 December 1996. Results. 2150 patients with gastrointestinal hemorrhage were investigated: 797 women and 1353 men. In 1856 patients (86.3%) we confirmed upper gastrointestinal tract hemorrhage. Complications of ulcer disease were the cause of hemorrhage in 863 patients (863/1856, 46.5%). The average age of our patients was 58 years (a 16-97 year span, SD +-16). Transendoscopic hemostasis with injection sclerotherapy (diluted adrenalin 1: 10,000 plus polidocanol 1%, Sclerovein preparation) and Nd-Yag laser (Medilas 2, MBB) photocoagulation was carried out in 381 cases (381/863, 44.1%). Repeated endoscopic hemostasis failed in 29 patients (29/381, 7.6%). Twelve patients (12/381, 3.1%) died during their hospital stay at medical wards. These deaths were the direct result of reebleeding. In 17 patients with acute hemorrhage (17/381, 4.5%) endoscopic hemostasis (in all cases injection sclerotherapy), did not prove successful and were treated operatively. During the postoperative period, 5 patients (5/17, 29.4%) died because of complication. The overall mortality rate of patients, treated with endoscopic hemostasis, was 6.5% (25/381), 2.6% (10/381) died already during the course of treatment at the Medical ICU or after surgical treatment. Conclusions. Peptic ulcer disease is the most significant cause of gastrointestinal hemorrhage. (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Peptična razjeda je najpogostejši vzrok krvavitve iz prebavne cevi. Namen študije je ugotoviti pogostost krvavitve iz peptične razjede pri bolnikih s krvavitvijo iz prebavne cevi v naši ustanovi v triletnem obdobju in ovrednotiti dejavnike tveganja pri tej vrsti krvavitve. Preiskovanci in način dela. Prospektivna študija zajema bolnike, pri katerih smo v obdobju od 1. januarja 1994 do 31. decembra 1996 endoskopsko preiskovali zgornja prebavila in opravljali endoskopsko hemostazo krvaveče peptične razjede. Rezultlati. Pregledali smo 2150 bolnikov; 797 žensk in 1353 moških. Pri 1856 bolnikih (86,3%) smo ugotovili krvavitev iz zgornje prebavne cevi. Peptično razjedo smo ugotovili pri 863 bolnikih (863/1856, 46,5%). Povprečna starost bolnikov je bila 58 let (v razponu od 16 do 97 let, SD +-16). Transendoskopsko hemostazo smo opravjali pri bolnikih s krvavečo peptično razjedo (381/863, 44,1%). Pri bolnikih (29/381, 3,1%) endoskopska hemostsaza ni bila uspešna. Dvanajst bolnikov (12/381, 3,1%) je umrlo med bolnišničnim zdravljenjem zaradi krvavitve. Pri 17 bolnikih z akutno krvavitvijo, ki smo jih zdravili z injekcijsko sklerozacijsko metodo (17/381, 4,5%), endoskopska hemostaza ni uspela in smo jih zdravili kirurško. V pooperativnem obdobju je 5 bolnikov (5/17, 29,4%) umrlo zaradi zapletov. Smrtnost bolnikov, ki smo jih zdravili z endoskopsko hemostazo, je bila 6,5% (25/381), 2,6% bolnikov (10/381) je umrlo že med zdravljenjem v enoti intenzivne medicine ali neposredno po operativnem posegu. Zaključki. Peptična razjeda je najpogostejši vzrok krvavitve iz zgornje prebavne cevi. Kravitve so pogoste pri starejših bolnikih, ki imajo običajno tudi druge bolezni. Te predstavljajo dejavnike tveganja tudi za operativno zdravljenje in zaplete po njem.
Descriptors		PEPTIC ULCER PEPTIC ULCER HEMORRHAGE ENDOSCOPY, DIGESTIVE SYSTEM HEMOSTASIS, ENDOSCOPIC GASTROINTESTINAL HEMORRHAGE MORTALITY HELICOBACTER PYLORI