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Сибирский научный медицинский журнал

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Современные подходы к эндоскопическому лечению пациентов с острыми неварикозными кровотечениями из верхних отделов желудочно-кишечного тракта

https://doi.org/10.18699/SSMJ20210601

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Аннотация

Острые кровотечения неварикозного характера из верхних отделов желудочно-кишечного тракта остаются актуальной клинической проблемой. Эпизоды кровотечения ассоциируются с высокой смертностью и значительной экономической нагрузкой на систему здравоохранения. Несмотря на продолжающееся улучшение методов эндоскопического гемостаза, рецидивы кровотечений и связанная с ними смертность остаются на достаточно высоком уровне. Помимо устоявшихся методов эндоскопического гемостаза (инъекционного, термического, механического), используемых как одиночно, так и в составе комбинированной терапии, в обзоре рассматриваются вопросы о применении новых видов эндоскопических устройств. Описаны результаты применения клипс over-the-scope, щипцов для горячей биопсии, методов топического гемостаза, эндоскопической ангиографии, радиочастотной абляции, криотерапии и эндоскопического сшивающего устройства. Рассмотрены технические аспекты их применения, вопросы эффективности и безопасности, преимущества и ограничения методов для достижения окончательного эндоскопического гемостаза. Проанализированы методы предварительной оценки и стратегии лечения при рецидивных кровотечениях и неудачном эндоскопическом гемостазе. Материал и методы. Поиск литературы проводился с использованием следующих электронных информационных ресурсов: CyberLeninka, PubMed, Nature Pathology, MEDLINE, PLoS ONE. Результаты. Комбинированный эндоскопический гемостаз является стандартным методом лечения пациентов с острыми неварикозными кровотечениями из верхних отделов желудочно-кишечного тракта, его эффективность составляет 95–98 %. Новые методы эндоскопического гемостаза способны обеспечить окончательный эндоскопический гемостаз как при первичном эндоскопическом лечении, так и при рецидиве кровотечения.

Об авторах

В. В. Дарвин
Сургутский государственный университет
Россия

Владимир Васильевич Дарвин, д.м.н., проф. 

628400, г. Сургут, ул. Ленина, 1



А. Я. Ильканич
Сургутский государственный университет
Россия

Андрей Яношевич Ильканич, д.м.н.

628400, г. Сургут, ул. Ленина, 1



М. Г. Рыжиков
Нижневартовская окружная клиническая больница
Россия

Михаил Григорьевич Рыжиков

628606, г. Нижневартовск, ул. Ленина, 18



А. В. Оганян
Нижневартовская окружная клиническая больница
Россия

Армен Валерьевич Оганян

628606, г. Нижневартовск, ул. Ленина, 18



А. В. Сатинов
Нижневартовская окружная клиническая больница
Россия

Алексей Владимирович Сатинов

628606, г. Нижневартовск, ул. Ленина, 18



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Рецензия

Для цитирования:


Дарвин В.В., Ильканич А.Я., Рыжиков М.Г., Оганян А.В., Сатинов А.В. Современные подходы к эндоскопическому лечению пациентов с острыми неварикозными кровотечениями из верхних отделов желудочно-кишечного тракта. Сибирский научный медицинский журнал. 2021;41(6):4-17. https://doi.org/10.18699/SSMJ20210601

For citation:


Darvin V.V., Ilkanich A.Y., Ryzhikov M.G., Oganian A.V., Satinov A.V. Modern management of acute non-variceal upper gastrointestinal bleeding. Siberian Scientific Medical Journal. 2021;41(6):4-17. (In Russ.) https://doi.org/10.18699/SSMJ20210601

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