NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING-GUIDELINES ON MANAGEMENT

作者：Celinski K^*; Cichoz Lach H; Madro A; Slomka M; Kasztelan Szczerbinska B; Dworzanski T

来源：Journal of Physiology and Pharmacology, 2008, 59: 215-229.

• non-variceal upper gastrointestinal bleeding
• endoscopy
• proton pomp inhibitor
• duodenal ulcer
• gastric ulcer

In gastroenterology non-variceal upper gastrointestinal bleeding is health hazard. Frequency of occurrence accounts for 40-150 cases per 100000 inhabitants with death rate of 7-14%. Researches which goal is to improve treatment effectiveness as well as to establish standardized procedures for managing patients with symptoms of non-variceal upper gastrointestinal bleedings have been conducted since many years. At the moment of admission, designed standards enable appropriate elaboration of patients' health state, referral to the right clinic and implementation of the most accurate treatment methods. Increase of suppression of primary bleeding as well as prevention of recurrence is associated with dynamic development of endoscopic treatment methods as well as with optimization of pharmacological treatment. In significant percentage, efficiency of non - variceal bleedings treatment depends on clinic's character (availability of equipment, experience of personnel) and on cooperation between several specialists (including gastroenterologist, surgeon, anesthetist, operative radiologist). Aim of the work is to present the latest evaluation of the mentioned subject, based on accessible literature. This work includes the basic principles for determination of bleeding intensity and risk of its recurrence as well as directions referring to fluids resuscitation and to monitoring of patients. Information on currently applied endoscopic methods for inhibition of non variceal upper gastrointestinal bleeding (injection, mechanical and thermo-coagulation techniques), comparison of their efficiency and possibility of application is provided in the work. The paper work also presents the newest directives for pharmacological treatment and guidelines for possible surgical treatment.

• 出版日期2008-8