ymjЯкутский медицинский журналYakut Medical Journal1813-19052312-1017ЯНЦ КМП10.25789/YMJ.2021.75.12ymj-539Research ArticleМЕТОДЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯMETHODS OF DIAGNOSIS AND TREATMENTДиагностика и лечение язвенных гастродуоденальных кровотеченийDiagnosis and treatment of ulcerative gastroduodenal bleedingИльканичА. Я.IlkanichA. Ya.

Ильканич Андрей Яношевич – д.м.н., доцент, проф. Медицинского института

Ilkanich Andrey Yanoshevich – M.D., Professor, the Department of Surgical Diseases, Medical Institute

ailkanich@yandex.ruДарвинВ. В.DarvinV. V.

Дарвин Владимир Васильевич – д.м.н. проф., зав. Кафедрой

Darvin Vladimir Vasilyevich – M.D., Professor, Head of the Department of Surgical Diseases

dvv@mf.surgu.ruРыжиковМ. Г.RyzhikovM. G.

Рыжиков Михаил Григорьевич – зав. отделением, врач-эндоскопист

Ryzhikov Mikhail Grigorievich – Head of the endoscopy department, endoscopist

orcchief@yandex.ruОганянА. В.OganianA. V.

Оганян Армен Валерьевич – врач-эндоскопист;

аспирант Медицинского института

Oganian Armen Valerievich – Endoscopist;

Postgraduate of the Department of Surgical Diseases, Medical Institute

niak1994@mail.ruСургутский гос. УниверситетРоссияSurgut State UniversityRussian FederationНижневартовская окружная клинич. БольницаРоссияNizhnevartovsk Regional Clinical HospitaRussian FederationНижневартовская окружная клинич. Больница; Сургутский гос. УниверситетРоссияNizhnevartovsk Regional Clinical Hospital; Surgut State UniversityRussian Federation202127042025034650Copyright © Ильканич А.Я., Дарвин В.В., Рыжиков М.Г., Оганян А.В., 20252025Ильканич А.Я., Дарвин В.В., Рыжиков М.Г., Оганян А.В.Ilkanich A.Y., Darvin V.V., Ryzhikov M.G., Oganian A.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://ymj.elpub.ru/jour/article/view/539

Язвенные гастродуоденальные кровотечения по-прежнему являются актуальной проблемой ургентной хирургии. В данном обзоре представлены современные данные о гастродуоденальных кровотечениях язвенной этиологии. Рассмотрены вопросы эпидемиологии и этиологии, диагностики и лечения язвенных гастродуоденальных кровотечений.

Ulcerative gastroduodenal bleeding remains an urgent problem in emergency surgery. This literature review presents modern data on gastroduodenal bleeding of ulcerative etiology. The review considers the issues of epidemiology and etiology, as well as diagnosis and treatment of ulcerative gastroduodenal bleeding.

язвенные гастродуоденальные кровотечениярецидив язвенного кровотеченияконсервативный гемостазэндоскопический гемостазpeptic ulcer bleedingpeptic ulcer bleeding relapseconservative hemostasisendoscopic hemostasisReferencesБогданович А.В. Структура и тактика лечения кровотечений из верхних отделов желудочно-кишечного тракта / А.В. Богданович, В.Н. Шиленок, Э.Я. Зельдин // Вестник Витебского государственного медицинского университета. – 2016. – Т. 15, №. 3. – С. 40-46.Bogdanovich A.V. The structure and tactics of treatment of upper gastrointestinal bleeding / A.V. Bogdanovich, V.N. Shilenok, E.Ia. Zeldin // Vitebsk State Medical University Herald. – 2016. – Т. 15. – No 3. – P. 40-46.Валеев М.В. Гастродуоденальные кровотечения. Анализ результатов лечения в условиях районной больницы. / М.В. Валеев, Ш.В. Тимербулатов // Вестник Национального медико-хирургического Центра им. Н.И. Пирогова. – 2020. – Т.15, №1. – С. 39-42. DOI: 0.25881/BPNMSC.2020.61.63.007Valeev M.V. Gastroduodenal bleedings. Treatment results analysis in a district hospital / M.V. Valeev, Sh.V. Timerbulatov // N.I. Pirogov’s National Medical and Surgical Center Herald. – 2020. – Т.15. – No 1. – P. 39-42. DOI: 10.25881/BPNMSC.2020.61.63.007Диагностика и лечение кровотечений из верхних отделов желудочно-кишечного тракта у больных острым нарушением мозгового кровообращения / М.П. Королев [и др.] // Педиатр. – 2019. – Т. 10, № 5. – С. 43–50. DOI: 10.17816/PED10543-50Diagnostics and treatment of upper gastrointestinal bleeding in patients with acute cerebral circulation accident / M.P. Korolev [et al.] // Pediatrician. – 2019. – Т. 10. – No 5. – P. 43–50. DOI: 10.17816/PED10543-50Российское общество хирургов. Язвенные гастродуоденальные кровотечения. Клинические рекомендации. – М.; Воронеж, 2014.Russian Surgeons Society. Ulcerative gastroduodenal bleeding. Clinical guidelines. Moscow – Voronezh. – 2014.Сравнительная оценка систем прогноза рецидива язвенного гастродуоденального кровотечения / Н.В. Лебедев [и др.] // Хирургия. Журнал им. Н.И. Пирогова. – 2013. – №. 8. – С. 28-31.Comparative assessment of recurrence of gastroduodenal ulcerative bleeding forecast systems / N.V. Lebedev [et al.] // Surgery. The Journal named after N.I. Pirogov. – 2013. – No. 8. – P. 28-31.Хирургическая тактика при язвенных гастродуоденальных кровотечениях / М.С. Кунафин [и др.] // Биологические науки. – С. 97.Surgical treatment strategy for ulcerative gastroduodenal bleeding / M.S. Kunafin [et al.] // Biological sciences. – P. 97.Эндоскопический гемостаз при кровотечении из верхних отделов желудочно-кишечного тракта / А.В. Кузнецов [и др.] // Междисциплинарные аспекты многопрофильной клиники: диагностика, лечение, профилактика. – 2018. – С. 72-78.Endoscopic hemostasis in cases of upper gastrointestinal bleeding / A.V. Kuznetsov [et al.] // Interdisciplinary aspects of multidisciplinary clinic: diagnosis, treatment, prevention. – 2018. – P. 72-78.Arima S. et al. Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial // Journal of gastroenterology. – 2010. – Т. 45. – №. 5. – P. 501-505. DOI: 10.1007/s00535-009-0186-8Arima S. et al. Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial // Journal of gastroenterology. – 2010. – Т. 45. – №. 5. – P. 501-505. DOI: 10.1007/s00535-009-0186-8Baracat F. et al. Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials // Surgical endoscopy. – 2016. – Т. 30. – №. 6. – P. 2155-2168. DOI: 10.1007/s00464-015-4542-xBaracat F. et al. Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials // Surgical endoscopy. – 2016. – Т. 30. – №. 6. – P. 2155-2168. DOI: 10.1007/s00464-015-4542-xBardou M. et al. Newer endoscopic therapies decrease both re-bleeding and mortality in high-risk patients with acute peptic ulcer bleeding: A series of meta-analyses // Gastroenterology. – 2003. – Т. 124. – №. 4. – P. A239. DOI: 10.1016/S0016-5085(03)81201-5Bardou M. et al. Newer endoscopic therapies decrease both re-bleeding and mortality in high-risk patients with acute peptic ulcer bleeding: A series of meta-analyses // Gastroenterology. – 2003. – Т. 124. – №. 4. – P. A239. DOI: 10.1016/S0016-5085(03)81201-5Changela K. et al. Hemostatic powder spray: a new method for managing gastrointestinal bleeding // Therapeutic advances in gastroenterology. – 2015. – Т. 8. – №. 3. – P. 125-135. DOI: 0.1177/1756283X15572587Changela K. et al. Hemostatic powder spray: a new method for managing gastrointestinal bleeding // Therapeutic advances in gastroenterology. – 2015. – Т. 8. – №. 3. – P. 125-135. DOI: 0.1177/1756283X15572587Chung W.C. et al. Clinical characteristics of Helicobacter pylori-negative drug-negative peptic ulcer bleeding // World Journal of Gastroenterology: WJG. – 2015. – Т. 21. – №. 28. – P. 8636. DOI: 10.3748/wjg.v21.i28.8636Chung W.C. et al. Clinical characteristics of Helicobacter pylori-negative drug-negative peptic ulcer bleeding // World Journal of Gastroenterology: WJG. – 2015. – Т. 21. – №. 28. – P. 8636. DOI: 10.3748/wjg.v21.i28.8636Daram S. et al. A Double Blind Randomized Study to Evaluate the Use of Metoclopramide before Endoscopy for Upper Gastrointestinal Bleeding // American Journal of Gastroenterology. – 2010. – T. 105. – P. 508Daram S. et al. A Double Blind Randomized Study to Evaluate the Use of Metoclopramide before Endoscopy for Upper Gastrointestinal Bleeding // American Journal of Gastroenterology. – 2010. – T. 105. – P. 508Fujishiro M. et al. Guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding // Digestive Endoscopy. – 2016. – Т. 28. – №. 4. – P. 363-378. DOI: 10.1111/den.12639Fujishiro M. et al. Guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding // Digestive Endoscopy. – 2016. – Т. 28. – №. 4. – P. 363-378. DOI: 10.1111/den.12639Gill K. R.S., Pooley R.A., Wallace M. B. Magnetic resonance imaging compatibility of endoclips // Gastrointestinal endoscopy. – 2009. – Т. 70. – №. 3. – P. 532-536. DOI: 10.1016/j.gie.2009.01.024Gill K. R.S., Pooley R.A., Wallace M. B. Magnetic resonance imaging compatibility of endoclips // Gastrointestinal endoscopy. – 2009. – Т. 70. – №. 3. – P. 532-536. DOI: 10.1016/j.gie.2009.01.024Gisbert J.P., Abraira V. Accuracy of Helicobacter pylori diagnostic tests in patients with bleeding peptic ulcer: a systematic review and meta-analysis // American Journal of Gastroenterology. – 2006. – Т. 101. – №. 4. – P. 848-863.Gisbert J.P., Abraira V. Accuracy of Helicobacter pylori diagnostic tests in patients with bleeding peptic ulcer: a systematic review and meta-analysis // American Journal of Gastroenterology. – 2006. – Т. 101. – №. 4. – P. 848-863.Gralnek I. et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline // Endoscopy. – 2015. – Т. 47. – №. 10. – P. a1-46-a46.Gralnek I. et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline // Endoscopy. – 2015. – Т. 47. – №. 10. – P. a1-46-a46.Grund K.E., Storek D., Farin G. Endoscopic argon plasma coagulation (APC) first clinical experiences in flexible endoscopy // Endoscopic surgery and allied technologies. – 1994. – Т. 2. – №. 1. – P. 42-46.Grund K.E., Storek D., Farin G. Endoscopic argon plasma coagulation (APC) first clinical experiences in flexible endoscopy // Endoscopic surgery and allied technologies. – 1994. – Т. 2. – №. 1. – P. 42-46.Hébuterne X., Vanbiervliet G. Feeding the patients with upper gastrointestinal bleeding // Current Opinion in Clinical Nutrition & Metabolic Care. – 2011. – Т. 14. – №. 2. – P. 197-201. DOI: 10.1097/MCO.0b013e3283436dc5Hébuterne X., Vanbiervliet G. Feeding the patients with upper gastrointestinal bleeding // Current Opinion in Clinical Nutrition & Metabolic Care. – 2011. – Т. 14. – №. 2. – P. 197-201. DOI: 10.1097/MCO.0b013e3283436dc5Jensen D.M. et al. Reassessment of rebleeding risk of Forrest IB (oozing) peptic ulcer bleeding in a large international randomized trial // The American journal of gastroenterology. – 2017. – Т. 112. – №. 3. – P. 441. DOI: 10.1038/ajg.2016.582Jensen D.M. et al. Reassessment of rebleeding risk of Forrest IB (oozing) peptic ulcer bleeding in a large international randomized trial // The American journal of gastroenterology. – 2017. – Т. 112. – №. 3. – P. 441. DOI: 10.1038/ajg.2016.582Kaminskis A. et al. Endoscopic hemostasis followed by preventive transarterial embolization in high-risk patients with bleeding peptic ulcer: 5-year experience // World Journal of Emergency Surgery. – 2019. – Т. 14. – №. 1. – P. 1-6. DOI: 10.1186/s13017-019-0264-zKaminskis A. et al. Endoscopic hemostasis followed by preventive transarterial embolization in high-risk patients with bleeding peptic ulcer: 5-year experience // World Journal of Emergency Surgery. – 2019. – Т. 14. – №. 1. – P. 1-6. DOI: 10.1186/s13017-019-0264-zKarstensen J.G. et al. Nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) cascade guideline // Endoscopy international open. – 2018. – Т. 6. – №. 10. – P. E1256.Karstensen J.G. et al. Nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) cascade guideline // Endoscopy international open. – 2018. – Т. 6. – №. 10. – P. E1256.Khoshbaten M. et al. Effects of early oral feeding on relapse and symptoms of upper gastrointestinal bleeding in peptic ulcer disease // Digestive endoscopy. – 2013. – Т. 25. – №. 2. – P. 125-129. DOI: 10.1111/j.1443-1661.2012.01347.xKhoshbaten M. et al. Effects of early oral feeding on relapse and symptoms of upper gastrointestinal bleeding in peptic ulcer disease // Digestive endoscopy. – 2013. – Т. 25. – №. 2. – P. 125-129. DOI: 10.1111/j.1443-1661.2012.01347.xLaine L. Bipolar-multipolar electrocoagulation of bleeding ulcers // Gastrointestinal Endoscopy Clinics. – 1991. – Т. 1. – №. 2. – P. 291-302.Laine L. Bipolar-multipolar electrocoagulation of bleeding ulcers // Gastrointestinal Endoscopy Clinics. – 1991. – Т. 1. – №. 2. – P. 291-302.Laine L., McQuaid K.R. Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials // Clinical Gastroenterology and Hepatology. – 2009. – Т. 7. – №. 1. – P. 33-47. DOI: 10.1016/j.cgh.2008.08.016Laine L., McQuaid K.R. Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials // Clinical Gastroenterology and Hepatology. – 2009. – Т. 7. – №. 1. – P. 33-47. DOI: 10.1016/j.cgh.2008.08.016Marshall B.J., Warren J.R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration // The lancet. – 1984. – Т. 323. – №. 8390. – P. 1311-1315.Marshall B.J., Warren J.R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration // The lancet. – 1984. – Т. 323. – №. 8390. – P. 1311-1315.Mokhtare M. et al. Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding // Clinical and Experimental Gastroenterology. – 2016. – Т. 9. – P. 337. DOI: 10.2147/CEG.S114860Mokhtare M. et al. Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding // Clinical and Experimental Gastroenterology. – 2016. – Т. 9. – P. 337. DOI: 10.2147/CEG.S114860Odutayo A. et al. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials // The Lancet Gastroenterology & Hepatology. – 2017. – Т. 2. – №. 5. – P. 354-360. DOI: 10.1016/S2468-1253(17)30054-7Odutayo A. et al. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials // The Lancet Gastroenterology & Hepatology. – 2017. – Т. 2. – №. 5. – P. 354-360. DOI: 10.1016/S2468-1253(17)30054-7Roy A. et al. The clinical and cost implications of failed endoscopic hemostasis in gastroduodenal ulcer bleeding // United European gastroenterology journal. – 2017. – Т. 5. – №. 3. – P. 359-364. DOI: 10.1177/2050640616663570Roy A. et al. The clinical and cost implications of failed endoscopic hemostasis in gastroduodenal ulcer bleeding // United European gastroenterology journal. – 2017. – Т. 5. – №. 3. – P. 359-364. DOI: 10.1177/2050640616663570Siau K. et al. Management of acute upper gastrointestinal bleeding: an update for the general physician // Journal of the Royal College of Physicians of Edinburgh. – 2017. – Т. 47. – №. 3. – P. 219. DOI: 10.4997/JRCPE.2017.303Siau K. et al. Management of acute upper gastrointestinal bleeding: an update for the general physician // Journal of the Royal College of Physicians of Edinburgh. – 2017. – Т. 47. – №. 3. – P. 219. DOI: 10.4997/JRCPE.2017.303Stanley A.J. et al. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study // bmj. – 2017. – Т. 356. DOI: 10.1136/bmj.i6432Stanley A.J. et al. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study // bmj. – 2017. – Т. 356. DOI: 10.1136/bmj.i6432Szary N.M. et al. Erythromycin prior to endoscopy in acute upper gastrointestinal bleeding: a meta-analysis // Scandinavian journal of gastroenterology. – 2011. – Т. 46. – №. 7-8. – P. 920-924. DOI:10.3109/00365521.2011.568520Szary N.M. et al. Erythromycin prior to endoscopy in acute upper gastrointestinal bleeding: a meta-analysis // Scandinavian journal of gastroenterology. – 2011. – Т. 46. – №. 7-8. – P. 920-924. DOI:10.3109/00365521.2011.568520Tsoi K.K.F., Hirai H.W., Sung J.J.Y. Meta-analysis: comparison of oral vs. intravenous proton pump inhibitors in patients with peptic ulcer bleeding // Alimentary pharmacology & therapeutics. – 2013. – Т. 38. – №. 7. – P. 721-728. DOI: 10.1111/apt.12441Tsoi K.K.F., Hirai H.W., Sung J.J.Y. Meta-analysis: comparison of oral vs. intravenous proton pump inhibitors in patients with peptic ulcer bleeding // Alimentary pharmacology & therapeutics. – 2013. – Т. 38. – №. 7. – P. 721-728. DOI: 10.1111/apt.12441Vergara M. et al. Epinephrine injection versus epinephrine injection and a second endoscopic method in high-risk bleeding ulcers // Cochrane Database of Systematic Reviews. – 2014. – №. 10. DOI: 10.1002/14651858.CD005584.pub3Vergara M. et al. Epinephrine injection versus epinephrine injection and a second endoscopic method in high-risk bleeding ulcers // Cochrane Database of Systematic Reviews. – 2014. – №. 10. DOI: 10.1002/14651858.CD005584.pub3Villanueva C. et al. Transfusion strategies for acute upper gastrointestinal bleeding // New England Journal of Medicine. – 2013. – Т. 368. – №. 1. – P. 11-21. DOI: 10.1056/NEJMoa1211801Villanueva C. et al. Transfusion strategies for acute upper gastrointestinal bleeding // New England Journal of Medicine. – 2013. – Т. 368. – №. 1. – P. 11-21. DOI: 10.1056/NEJMoa1211801Wang J. et al. Restrictive vs liberal transfusion for upper gastrointestinal bleeding: a meta-analysis of randomized controlled trials // World journal of gastroenterology: WJG. – 2013. – Т. 19. – №. 40. – P. 6919. DOI: 10.3748/wjg.v19.i40.6919Wang J. et al. Restrictive vs liberal transfusion for upper gastrointestinal bleeding: a meta-analysis of randomized controlled trials // World journal of gastroenterology: WJG. – 2013. – Т. 19. – №. 40. – P. 6919. DOI: 10.3748/wjg.v19.i40.6919Wong T.C.L. et al. A comparison of angiographic embolization with surgery after failed endoscopic hemostasis to bleeding peptic ulcers // Gastrointestinal endoscopy. – 2011. – Т. 73. – №. 5. – P. 900-908. DOI: 10.1016/j.gie.2010.11.024Wong T.C.L. et al. A comparison of angiographic embolization with surgery after failed endoscopic hemostasis to bleeding peptic ulcers // Gastrointestinal endoscopy. – 2011. – Т. 73. – №. 5. – P. 900-908. DOI: 10.1016/j.gie.2010.11.024

The authors declare that there are no conflicts of interest present.