Bleeding

At the present stage reduces the number of operations in ulcerative brand viagra online gastro-intestinal bleeding. The emergence of modern antisecretory farmakopreparatov and widespread implementation of endoscopic and endovascular methods of hemostasis has led to a decrease in the number of urgent surgical intervention in patients with high risk of rebleeding in 4 times. Decreased by 10 times the number of such minimal operations for ulcer bleeding, as suturing wounds. They do not give the expected hemostatic effect and are accompanied by high mortality. Modified surgical approach in elderly patients has led to a decrease in postoperative mortality from 15.8 to 5.8% and overall mortality from 15.8 to 9.6%.

Key words: peptic ulcer; elderly; gastrointestinal bleeding.
SUMMARY

At the present stage the number of operations is reduced at a ulcer gastroenteric bleeding. Occurrence modern antysecretor drags and wide introduction endoscopic and endovascular methods of hemostasis has led to decrease of urgent operative interventions in group of patients with high risk of rebleeding in 4 times. The number of such minimal operations was reduced in 10 times. They do not give expected hemostasis effect and are accompanied high mortality. Change of surgical tactics at elderly patients has led to decrease postoperative mortality from 15,8 up to 5,8% and the general mortality from 15,8 up to 9,6%.

Keywords: peptic generic viagra ulcer disease; advanced age; gastrointestinal bleeding.

For many years, diagnosis and treatment of peptic ulcer disease remains an urgent medical problems. The most frequent complication of peptic ulcer disease is gastrointestinal bleeding, in recent decades have seen an increase in the frequency of ulcers of gastrointestinal bleeding in the older age group to 48% compared to 2% in the seventies of last century. This is due to concomitant diseases and uncontrolled intake of aspirin or nonsteroidal anti-inflammatory drug (NSAID) elderly patients. According to statistics, in Russia at the end of XX century, pensioners made up about 21% of the population and 14-40% - in the structure of peptic ulcer disease. Results of treatment of complications of peptic ulcer in the elderly provide the highest mortality, gastrointestinal bleeding and 59% higher than in 3 or more of these indicators in young patients [1, 2, 3].

In recent decades, reviewed the issue of treatment of complicated forms of peptic ulcer in the direction of more conservative methods, such a tactic is particularly true in brand name levitra elderly patients.

Currently the world reducing the number of operations in ulcerative gastro-intestinal bleeding [4, 5, 6]. This is due to the progress of pharmacotherapy of peptic ulcer and the widespread introduction of endoscopic and endovascular stop bleeding ulcer. According to Alexander S. Ermolov, marked reduction of total mortality in the treatment of gastroduodenal hemorrhage in the clinics of Moscow, where operational activity cialis without prescription decreased from 24 to 17%, while the minimum mortality rate - 5.7% - says the clinics where operational activity does not exceed 10 %. [2]
MATERIAL AND METHODS

During the period 1990-2008. in the Clinical Hospital № 15 named. M. Filatov, Moscow treated 999 patients over 60 years with ulcerative gastro-intestinal bleeding. Of them operated only 197 (19,7%). Most elderly patients - 802 (80,3%) - were treated conservatively.

We adhere to the individually-differentiated strategy in patients with ulcerative gastro-intestinal bleeding.

All the patients with the clinic of gastrointestinal bleeding on admission performed emergency endoscopy with active interventions to stop the continuous bleeding or generic levitra prevent its recurrence. When continuous bleeding is carried out endoscopic hemostasis, which includes all available clinical methods: obkalyvanie alcohol-novocaine mixture, electrocoagulation, laser coagulation, radiokoagulyatsiyu apparatus "Surgitron.

In the absence of active bleeding at the time of the inspection is performed endoscopic prevention of rebleeding and evaluation of rebleeding in the light of clinical and endoscopic criteria for the classification of A. Forrest. While maintaining high clinical and endoscopic rebleeding after day after endoscopic therapy raises the question of urgent surgical treatment. In case of failure of endoscopic manipulation of patients treated in the emergency order.

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