CYP2C9 va PLA2G7 genlari polimorfizmini hisobga olgan holda gastroduodenal qon ketishi bilan ogʻrigan bemorlarda davolash taktikasi
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Annotatsiya
Objective: To analyze the outcomes of conservative and surgical treatment in patients with gastroduodenal bleeding in order to determine optimal treatment tactics and choose the scope and nature of surgical intervention, taking genetic predisposition into account. Results: A prospective analysis was conducted of the treatment outcomes of 1,792 patients treated for gastric and duodenal ulcers at the clinic of the Department of Surgical Diseases of the Medical Academy, based at City Clinical Hospital No. 1. Polymorphisms of the CYP2C9 and PLA2G7 genes were specifically studied in 110 patients with duodenal bleeding. Of the total cohort, 1,241 patients were treated for complicated bleeding; in 138 cases, the bleeding was of non-ulcerative etiology, and in 299 cases, chronic gastric and duodenal ulcers were identified. Ninety-eight patients underwent surgery for stenosis and 114 for perforation. The algorithm of therapeutic measures depended on the results of gastroduodenoscopy; a combination of electrocoagulation and injection methods was most often used for hemostasis. After primary endoscopic hemostasis, recurrence developed in 37 cases, requiring suturing of the bleeding vessel. Among 101 patients, conservative tactics were used in 63.5% of cases, with a mortality rate of 5.5%. Conclusions: According to our data, in recent years, bleeding has predominated among the complications of gastric and duodenal ulcers, accounting for 69.3%, while perforation and stenosis accounted for 6.4% and 5.4%, respectively.