THE MEDICAMENTOSE AND ENDOSCOPIC TREATMENT OF NONVARICEAL UPPER GASTROINTESTINAL BLEEDING

Session

Medicine and Nursing

Description

The endoscopic treatment is one of the most common therapy for bleeding peptic ulcer. Administration of PPI after successful injected therapy with epinephrine is of great importance. This study has the aim to show the efficacy of the PPI treatment after endoscopic injected of epinephrine in the patients with bleeding peptic ulcer.

METHODS. In this study are included 102 patients with active bleeding or with nonbleeding visible vessels, after beginner hemostasis with endoscopic injection of epinephrine (1:10 000). These patients are randomized in two groups. The first group with 22 patients were treated with PPI, 40 mg pantoprazole infusion every 6 hours for 3 days and the second group with 80 patients were treated with 50 mg ranitidine infusion every 8 hours for 3 days. All the patients were followed for survey characteristics during 14 days after the first examination.

RESULTS. Episodes of rebleeding were lower in the group of patients treated with PPI every 6 hours, 7.1% (2/28) compared with the group of patients treated with Ranitidine every 8 hours, 15% (12/80). The volume of the transfused blood in the group of patients treated with PPI was lower than in the group of patients treated with ranitidine, 930 ml vs 1540 ml and p<0.001. The days of hospital stay (9 vs 11 , P>0.05) Number of patients who need the surgical intervention (10.7% vs 12.5% , P> 0.05) and mortality rate (3.6% vs 6.25% , P> 0.05) were without statistically significance between two groups.

CONCLUSION. Combination of the endoscopic epinephrine injection and administration of high doses of PPI in infusion was more effective than combination of endoscopic injection with epinephrine and ranitidine in infusion for prevention of the re-bleeding from peptic ulcer with active bleeding or nonbleeding visible vessels.

Keywords:

Upper gastrointestinal bleeding, endoscopic treatment, IPP, H2RA

Session Chair

Syheda Latifi Hoxha

Session Co-Chair

Shqiptar Demaçi

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-550-19-2

Location

Pristina, Kosovo

Start Date

26-10-2019 3:30 PM

End Date

26-10-2019 5:00 PM

DOI

10.33107/ubt-ic.2019.312

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Oct 26th, 3:30 PM Oct 26th, 5:00 PM

THE MEDICAMENTOSE AND ENDOSCOPIC TREATMENT OF NONVARICEAL UPPER GASTROINTESTINAL BLEEDING

Pristina, Kosovo

The endoscopic treatment is one of the most common therapy for bleeding peptic ulcer. Administration of PPI after successful injected therapy with epinephrine is of great importance. This study has the aim to show the efficacy of the PPI treatment after endoscopic injected of epinephrine in the patients with bleeding peptic ulcer.

METHODS. In this study are included 102 patients with active bleeding or with nonbleeding visible vessels, after beginner hemostasis with endoscopic injection of epinephrine (1:10 000). These patients are randomized in two groups. The first group with 22 patients were treated with PPI, 40 mg pantoprazole infusion every 6 hours for 3 days and the second group with 80 patients were treated with 50 mg ranitidine infusion every 8 hours for 3 days. All the patients were followed for survey characteristics during 14 days after the first examination.

RESULTS. Episodes of rebleeding were lower in the group of patients treated with PPI every 6 hours, 7.1% (2/28) compared with the group of patients treated with Ranitidine every 8 hours, 15% (12/80). The volume of the transfused blood in the group of patients treated with PPI was lower than in the group of patients treated with ranitidine, 930 ml vs 1540 ml and p<0.001. The days of hospital stay (9 vs 11 , P>0.05) Number of patients who need the surgical intervention (10.7% vs 12.5% , P> 0.05) and mortality rate (3.6% vs 6.25% , P> 0.05) were without statistically significance between two groups.

CONCLUSION. Combination of the endoscopic epinephrine injection and administration of high doses of PPI in infusion was more effective than combination of endoscopic injection with epinephrine and ranitidine in infusion for prevention of the re-bleeding from peptic ulcer with active bleeding or nonbleeding visible vessels.