V. Rusyn, Konstantin E. Rumiantsev, Andriy A. Rusyn, O. Balazh
{"title":"肝硬化并发食管静脉曲张出血、脑病、腹水的综合治疗","authors":"V. Rusyn, Konstantin E. Rumiantsev, Andriy A. Rusyn, O. Balazh","doi":"10.36740/emems202203104","DOIUrl":null,"url":null,"abstract":"Aim: To develop a complex treatment for patients with decompensated cirrhosis in case of bleeding from the varicose veins of the esophagus. \nMaterial and methods: With bleeding from varicose veins of the esophagus for the period 2015–2020. in the clinic of the Transcarpathian Regional Clinical Hospital. A. Novak examined and treated 64 patients with C-class liver cirrhosis according to the Child-Turcotte-Pugh criteria. \nResults: In 17 patients they used extracorporeal ultrafiltration of ascitic fluid with it’s subsequent intravenous reinfusion. In the subgroup of 39 patients with effective sclerotherapy the mortality rate was 23.1%. In the subgroup of 25 patients where the ES was ineffective and the Blackmore tube was applied, the mortality rate was 32%. Among the 20 patients after laparocentesis with ascitic fluid evacuation 8 (40%) died. In the 17 patients after extracorporeal ultrafiltration of ascitic fluid with its subsequent intravenous reinfusion 2 (11.8%). In the subgroup where albumin peritoneal dialysis was applied 7 patients died (25.9%). \nConclusions: The prognostic factors for the lethal outcome of bleeding from varicose veins of the esophagus in patients with decompensated liver cirrhosis are: the ineffectiveness of endoscopic sclerotherapy as a means of primary hemostasis, bleeding recurrence in the first 5 days. The use of staged treatment using extracorporeal methods can significantly improve the results of treatment, reduce mortality.","PeriodicalId":433523,"journal":{"name":"Emergency Medical Service","volume":"26 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"COMPREHENSIVE TREATMENT OF COMPLICATED COURSE OF LIVER CIRRHOSIS IN CASE OF BLEEDING FROM THE VARICOS VEINS OF ESOPHAGUS, ENCEPHALOPATHY AND ASCITES\",\"authors\":\"V. Rusyn, Konstantin E. Rumiantsev, Andriy A. Rusyn, O. Balazh\",\"doi\":\"10.36740/emems202203104\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: To develop a complex treatment for patients with decompensated cirrhosis in case of bleeding from the varicose veins of the esophagus. \\nMaterial and methods: With bleeding from varicose veins of the esophagus for the period 2015–2020. in the clinic of the Transcarpathian Regional Clinical Hospital. A. Novak examined and treated 64 patients with C-class liver cirrhosis according to the Child-Turcotte-Pugh criteria. \\nResults: In 17 patients they used extracorporeal ultrafiltration of ascitic fluid with it’s subsequent intravenous reinfusion. In the subgroup of 39 patients with effective sclerotherapy the mortality rate was 23.1%. In the subgroup of 25 patients where the ES was ineffective and the Blackmore tube was applied, the mortality rate was 32%. Among the 20 patients after laparocentesis with ascitic fluid evacuation 8 (40%) died. In the 17 patients after extracorporeal ultrafiltration of ascitic fluid with its subsequent intravenous reinfusion 2 (11.8%). In the subgroup where albumin peritoneal dialysis was applied 7 patients died (25.9%). \\nConclusions: The prognostic factors for the lethal outcome of bleeding from varicose veins of the esophagus in patients with decompensated liver cirrhosis are: the ineffectiveness of endoscopic sclerotherapy as a means of primary hemostasis, bleeding recurrence in the first 5 days. The use of staged treatment using extracorporeal methods can significantly improve the results of treatment, reduce mortality.\",\"PeriodicalId\":433523,\"journal\":{\"name\":\"Emergency Medical Service\",\"volume\":\"26 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1900-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Emergency Medical Service\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36740/emems202203104\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency Medical Service","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36740/emems202203104","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
COMPREHENSIVE TREATMENT OF COMPLICATED COURSE OF LIVER CIRRHOSIS IN CASE OF BLEEDING FROM THE VARICOS VEINS OF ESOPHAGUS, ENCEPHALOPATHY AND ASCITES
Aim: To develop a complex treatment for patients with decompensated cirrhosis in case of bleeding from the varicose veins of the esophagus.
Material and methods: With bleeding from varicose veins of the esophagus for the period 2015–2020. in the clinic of the Transcarpathian Regional Clinical Hospital. A. Novak examined and treated 64 patients with C-class liver cirrhosis according to the Child-Turcotte-Pugh criteria.
Results: In 17 patients they used extracorporeal ultrafiltration of ascitic fluid with it’s subsequent intravenous reinfusion. In the subgroup of 39 patients with effective sclerotherapy the mortality rate was 23.1%. In the subgroup of 25 patients where the ES was ineffective and the Blackmore tube was applied, the mortality rate was 32%. Among the 20 patients after laparocentesis with ascitic fluid evacuation 8 (40%) died. In the 17 patients after extracorporeal ultrafiltration of ascitic fluid with its subsequent intravenous reinfusion 2 (11.8%). In the subgroup where albumin peritoneal dialysis was applied 7 patients died (25.9%).
Conclusions: The prognostic factors for the lethal outcome of bleeding from varicose veins of the esophagus in patients with decompensated liver cirrhosis are: the ineffectiveness of endoscopic sclerotherapy as a means of primary hemostasis, bleeding recurrence in the first 5 days. The use of staged treatment using extracorporeal methods can significantly improve the results of treatment, reduce mortality.