Saratov JOURNAL of Medical and Scientific Research

Evaluation of the operative and anesthetic risk for patients with ulcerative gastroduodenal bleedings

Year: 2014, volume 10 Issue: №4 Pages: 663-669
Heading: Surgery Article type: Original article
Authors: Potakhin S.N., Shapkin Yu.G.
Organization: Saratov State Medical University

Aim: to specify operative and anesthetic risk during urgent and preventive operations for patients with ulcerative gastroduodenal bleedings, develop algorithm for prognosis of unfavorable outcomes after operations and point out possible ways to control risks in given pathology. Material and Methods. To specify factors of operative and anesthetic risk during urgent and preventive operations a comparative analysis of two groups of patients suffering from gastroduodenal bleedings, who were treated in the surgery department of "Saratov city clinical hospital Nr.6" was done. The first group consisted of 39 patients, who died after the surgery, the second group of 274 patients with a favorable outcome after the operation. The statistical analysis was done by use of the program Statistica 6.0. Results. The operative and anesthetic risk factors where determined with the help of parametric and non-parametric methods of statistical analysis. An algorithm of evaluation operative and anesthetic risk factors by a tree classification was devised through the use of multidimensional analysis. With the help of this one can predict the outcome of urgent and preventive operations and highlight the risk group with an expected lethality of about 40%. Conclusion. The division of patients according to degree of risk of bleeding relapses as a whole with complex evaluation of patient's condition severity and operative and anesthetic risk allows choosing the right treatment plan and by this as a result increases the chance for a favorable treatment outcome.

1. Ulcerative gastroduodenal bleedings: a project of national clinical recommendations on the basis of materials by the Russian surgical federation plenum. Voronezh, 2014
2. Potakhin S.N., Shapkin Yu.G., Chalyk Yu.V., Zevyakina V.A. Evaluation of severity and prognosis of the disease course in ulcerative gastroduodenal bleeding (review). Saratov Journal of Medical Scientific Research 2014; 10 (2): 301-307
3. Shapkin Yu.G., Potahin S.N. The dynamics of main indicators for the treatment of ulcerative gastroduodenal bleedings: the analysis of several years studies. Saratov Journal of Medical Scientific Research 2014; 10 (3): 456-460
4. Gidirum GP, Tshikala ЕT., Gucu VM, Koncu Gl Tactics for gastrointestinal bleedings under air ambulance conditions. Surgery 1992; (9-10): 24-28
5. Shapkin Y.G. Surgical management for gastroduodenal bleedings. Saratov: Saratov Medical University, 1998; 245 p.
6. Proceedings of organization of medico-diagnostic aid for nonvaricose gastrointestinal bleeding (from chronic ulcers of the stomach, duodenum and peptic ulcers. Vestnik khirurgii named after I.I. Grekov 2012; 171 (5): 94-101
7. Kornmasov E.A., Matshechin P.V., Tshernishev V.N.,etal. Clinical protocol for diagnostic and treatment of ulcerative gastroduodenal bleedings in Samara region. Samara: Samara State Medical University, 2013; 20 p.

2014_04_663-669.pdf1.07 MB

No votes yet