nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-242-10-65-70nogr-3247Research ArticleХИРУРГИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯSURGICAL GASTROENTEROLOGYТактика лечения острых гастродуоденальных язвенных кровотечений у пациентов с ишемической болезнью сердцаTactics of treatment of acute gastroduodenal ulcerative bleeding in patients with ischemic heart diseasehttps://orcid.org/0000-0002-3335-525XМагомедовМ. М.MagomedovM. M.noemail@neicon.ruhttps://orcid.org/0009-0004-2107-1016МагомедовА. А.MagomedovA. A.magomedov_666@inbox.ruhttps://orcid.org/0000-0003-2232-0147АбдулжалиловМ. К.AbdulzhalilovM. K.noemail@neicon.ruhttps://orcid.org/0000-0001-5175-4097МагомедовМ. А.MagomedovM. A.noemail@neicon.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Дагестанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Dagestan State Medical University” of the Ministry of Health of the Russian FederationRussian Federation2025270120260106570Copyright © Магомедов М.М., Магомедов А.А., Абдулжалилов М.К., Магомедов М.А., 20262026Магомедов М.М., Магомедов А.А., Абдулжалилов М.К., Магомедов М.А.Magomedov M.M., Magomedov A.A., Abdulzhalilov M.K., Magomedov M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/3247

Цель. Оценить результаты лечения острых гастродуоденальных язвенных кровотечений у больных с ишемической болезнью сердца. Материалы и методы. Проведено ретроспективное исследование 174 пациентов с ишемической болезнью сердца, находившихся на стационарном лечении с диагнозом острое гастродуоденальное язвенное кровотечение в период с 2016 по 2024 гг. Среди пациентов мужчин было 112(64,4%), женщин - 62 (35,6%). Возраст больных в среднем составил 68,4±8,7 года. Результаты. Эффективность первичного эндоскопического гемостаза составила 80,5%. В 19,5% случаев потребовалось применение альтернативных методов. Транскатетерная артериальная эмболизация была проведена 14,9% пациентов, с достижением технического успеха в 92,3% случаев. Хирургическое вмешательство потребовалось 4,6% пациентам, у которых наблюдался рецидив кровотечения после неэффективности эндоскопических и эндоваскулярных методов. Заключение. Наиболее надежным и безопасным методом гемостаза у больных с ишемической болезнью сердца является эндоваскулярный метод, который характеризуется самой низкой частотой рецидивов кровотечения (7,7%). Сочетание ишемической болезни сердца и острого гастродуоденального язвенного кровотечения вызывает диагностические трудности, что требует мультидисциплинарного подхода как от хирурга, так и от кардиолога, для определения приоритетного лечения.

Objectives. To evaluate the results of treatment of acute gastroduodenal ulcerative bleeding in patients with ischemic heart disease. Materials and methods. A retrospective study of 174 patients with ischemic heart disease who were hospitalized with acute gastroduodenal ulcerative bleeding in the period from 2016 to 2024 was conducted. There were 112 men (64.4%) and 62 women (35.6%) among the patients. The average age of the patients was 68.4±8.7 years. Results. The efficiency of primary endoscopic hemostasis was 80.5%. In 19.5% of cases, alternative methods were required. Transcatheter arterial embolization was performed in 14.9% of patients, with technical success in 92.3% of cases. Surgical intervention was necessary in 4.6% of patients who experienced a recurrence of bleeding after the ineffectiveness of endoscopic and endovascular methods. Conclusion. The most reliable and safe method of hemostasis in patients with ischemic heart disease is the endovascular method, which is characterized by the lowest frequency of bleeding recurrence (7.7%). The combination of ischemic heart disease and acute gastroduodenal ulcerative bleeding causes diagnostic difficulties, which requires a multidisciplinary approach from both a surgeon and a cardiologist to determine the priority treatment.

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