md-medicaldata

Authors

 

Predrag Petrović ¹, Ivanka Perčić¹, Aleksandar Knežević¹, Rada Tešić¹, Bojan Vuković¹, Danka Petrović<sup>2

1</sup>Urgentni centar, Odeljenje urgentne interne medicine Klinički centar Vojvodine
²Centar za radiologiju Klinički centar Vojvodine

 

The paper was received on: 01.02.2017./ Accepted on 20.02.2017.

 

Correspondence to

Predrag Petrović
Doža Đerđa 2, 21000 Novi Sad,
lekar specijalista interne medicine- gastroenterologije i hepatologije.
tel. 064/2615784
e-mail: ppetrovicnovisad@gmail.com

 

 

Abstract

 

Introduction: Despite the increasing knowledge on the etiology and treatment of bleeding from the upper gastrointestinal tract (GPGIT) as well as the development of endoscopic surgery to stop the bleeding number of hospitalizations and mortality did not decrease. A possible explanation is all the more massive use of antiplatelet, anticoagulant and non-steroidal anti-inflammatory drugs, or the aging of the population. Materials and Methods: This paper presents an analysis of 266 patients who were admitted to UC KCV in the period from 01.01.2013 to 30.06.2013 g. Everyone made an urgent EGDS. The study was retrospective. Results: Of 266 male patients was 176 and the female 89. In relation to the half there was a statistically significant difference.After emergency EGDS non-variceal bleeding had 239 (89.8%) and variceal 27 (10.2%). No there statistically significant difference between the two groups as far as the age and sex distribution. Patients with bleeding non-variceal were markedly more likely to have melena (p = 0.001) and were more likely to use NSAIDs and ASA (p = 0.023; p = 0.002). Also this group of patients was statistically significantly more frequently had a previous ulcer disease (p = 0.010) and cardiovascular disease (p = 0.036). Patients with variceal bleeding significantly more likely to consume alcohol (p = 0.000) and had anemia with hemoglobin values of 60 -90 g / l (p = 0.001), and thrombocytopenia (0.000) and prolonged PT (0,000). Patients with bleeding non-variceal significantly more often were presented with acute renal failure (p = 0.001). Conclusion: Acute bleeding from GPGIT are one of the most urgent conditions in medicine. An increasing number of patients with bleeding from GPGIT which is explained by the increasing use of antiplatelet, anticoagulant and non-steroidal anti-inflammatory drugs. Timely diagnosis (urgent EGDS) and treatment reduces the mortality of these bolsnika.

 

Key words

Upper gastrointestinal bleeding; Urgent endoscopay; Antiplatelet therapy;  non-steroidal anti-inflammatory drugs.

 

 

 

Sažetak

 

Uvod: I pored sve većeg znanja o etiologiji i načinu lečenja krvarenja iz gornjih partija gastrointestinalnog trakta (GPGIT) kao i razvoju endoskopskih tehnika zaustavljanja krvarenja broj hospitalizacija i smrtnost nisu se smanjili. Moguće objašnjenje je sve masovnija upotreba antiagregacionih, antikoagulantnih i nesteroidnih antiinflamatornih lekova ali i starenje populacije. Materijal i metode: Ovaj rad predstavlja analizu 266 bolesnika koji su primljeni u UC KCV u periodu od 01.01.2013 do 30.06.2013 g. Svima je načinjena urgentna EGDS. Studija je bila retrospektivna. Rezultati: Od 266 bolesnika muškog pola je bilo 176 a ženskog 89. U odnosu na pol postoji statistički značajna razlika. Nakon urgentne EGDS nevaricealno krvarenje je imalo 239 (89,8%) a varicealno 27 (10,2%). Nie postojala statitički značaja razlika između ove dve grupe što se tiče starosne i polne strukture. Bolesnici sa nevaricealnim krvarenjem su značano češće imali melene (p=0,001) i češće su upotrebljavali NSAIL i ASA (p= 0,023; p= 0,002). Takođe ova grupa bolesnika je statistički značajno češće imali predhodnu ulkusnu bolest (p= 0,010) i bolesti KVS (p=0,036). Bolesnici sa varicealnim krvarenjem statistički značajno češće konzumirali alkohol (p= 0,000) i imali su anemiju sa vrednostima Hgb od 60 -90 g/l ( p= 0,001) i trombocitopeniju (0,000) kao i produžen PT ( 0,000). Bolesnici sa nevaricealnim  krvarenjem statistički značajno češće su se prezentovali sa akutnom bubrežnom insuficijencijom (p= 0,001). Zaključak: Akutna krvarenja iz GPGIT predstavljaju jedno od najurgentnijih stanja u medicini. Sve je veći broj bolesnika sa krvarenjem iz GPGIT što se objašnjava sve većom upotrebom antiagregacione, antikoagulantne i nesteroidnih antiinflamatornih lekova. Pravovremena dijagnostika (urgentna EGDS) i lečenje smanjuje mortalitet ovih bolesnika.

 

 

Ključne reči

Krvarenje iz gornjih partija gastrointestinalnog trakta, urgentna ezofagogastroduodenoskopija, antiagregaciona terapija, nesteroidni antiinflamatorni lekovi.

 

 

 

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PDF Petrović P. et al. • MD-Medical Data 2017;9(1): 045-049