ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ PHẪU THUẬT XUẤT HUYẾT TIÊU HÓA CAO TẠI BỆNH VIỆN K

Abstract

Upper gastrointertinal hemorrhage is  medical and surgical urgency. In recent years, there are more patients hospitalized in the state of hypovolemic shock  or instable hemodynamic state  needed  blood transfusion and intervention by urgent gastroscopy for hemostasis or  emmergency surgery. We threrefore conduct ours retrospective study aim at evaluating of  the clinic features and surgical results of upper gastrointertinal hemmorage patients in K hospital. Patient and method: Retrospective study. Time: 1/2019-12/2020. Results: 28 patiens, male 23 (82,1%), female: 5(17,9%), mean age: 61,0. History of gastric-duodenal ulcer or perforation  is 50,0%. Clinic: 17,8% in state of hypovolemic shock, hematemesis and melena in 35,7%, melena in 64,3%, Forrest IA-IB in 25,0%. Blood transfusion in 82,1%. Urgent operations performed in 25,0%, delayed urgent operation in 21,4%. Among them: 78,6% gastric bleeding cancer, 14,3% duoenal bleeding ulcer; 7,1% gastric bleeding ulcer. There is no death per and postoperation, 1 patient had bile leakage that stopped by continuous aspiration, 1 patient rebleeded post duoenal ulcer suture  stopped by PPI continuous transfusion. We conclude that upper gastrointertinal hemorrage in K hospital had the lesions of  gastric bleeding cancer,gastric bleeding ulcer, duodenalbleeding ulcer  with the proportion: 78,6%, 7,1%, 14,3% relatively. Of them, the most serious state are duodenal bleeding ulcer perforated to gastroduodenal artery that difficult to place Clip or injection  for hemostasis by gastroscopy and to operate in the state of hypovolemic shock.