CHOICE OF HEMOSTASIS METHOD FOR ACUTE GASTROINTESTINAL ULCERATIVE BLEEDING IN PATIENTS OF ADVANCED AND ELDERLY AGE IN CONDITIONS OF POLYMORBIDITY

Acute ulcerative gastroduodenal bleeding is one of the most common conditions requiring emergency medical care. A special group is elderly and senile patients. The overall mortality in this group of patients reaches 40 %. The aim of the study: to improve the results of surgical treatment of ulcerative gastroduodenal bleeding in elderly and senile patients in conditions of polymorbidity, by studying the effectiveness of various methods of pharmacological, endoscopic and surgical hemostasis. Material and methods. The results of clinical examination and treatment of 190 patients with ulcerative gastroduodenal bleeding were analyzed. The main group included 165 (86.8 %) patients. The control group consisted of 25 (13.2 %) patients. Nonoperative and operative hemostasis methods were used to stop bleeding. Research results. In elderly and senile patients with gastroduodenal ulcer bleeding, the main treatment was the appointment of hemostatic and blood replacement therapy. Among endoscopic methods of hemostasis, sclerosing solutions of the bleeding vessel were performed in 54 (28.4 %) patients; clipping was used in 46 (24.2 %) patients; argon plasma coagulation in 39 (20.5 %) patients. Treatment of gastroduodenal ulcer bleeding in patients of the control group was performed by surgical correction: ulcer excision in 10 (40 %) patients, ulcer exteriorization in 6 (24 %) patients, sectoral resection of the stomach in 4 (16 %), Billroth-I gastric resection in 3 (12 %) patients and ulcer stitching in 2 (8 %) patients. Conclusions: comprehensive treatment of ulcerative gastrointestinal bleeding in patients with comorbid diseases using modern methods of endohemostasis and conservative therapy in most cases allows for the final cessation of bleeding.