{"?xml":{"@version":"1.0"},"edm:RDF":{"@xmlns:dc":"http://purl.org/dc/elements/1.1/","@xmlns:edm":"http://www.europeana.eu/schemas/edm/","@xmlns:wgs84_pos":"http://www.w3.org/2003/01/geo/wgs84_pos","@xmlns:foaf":"http://xmlns.com/foaf/0.1/","@xmlns:rdaGr2":"http://rdvocab.info/ElementsGr2","@xmlns:oai":"http://www.openarchives.org/OAI/2.0/","@xmlns:owl":"http://www.w3.org/2002/07/owl#","@xmlns:rdf":"http://www.w3.org/1999/02/22-rdf-syntax-ns#","@xmlns:ore":"http://www.openarchives.org/ore/terms/","@xmlns:skos":"http://www.w3.org/2004/02/skos/core#","@xmlns:dcterms":"http://purl.org/dc/terms/","edm:WebResource":[{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:DOC-00UHVAKJ/26d69268-e3a4-4e5e-810e-ff6fd70d574b/PDF","dcterms:extent":"114 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:DOC-00UHVAKJ/962b24bb-5cb2-4625-b6e1-0b0f7af5c69e/TEXT","dcterms:extent":"41 KB"}],"edm:TimeSpan":{"@rdf:about":"1929-2026","edm:begin":{"@xml:lang":"en","#text":"1929"},"edm:end":{"@xml:lang":"en","#text":"2026"}},"edm:ProvidedCHO":{"@rdf:about":"URN:NBN:SI:DOC-00UHVAKJ","dcterms:isPartOf":[{"@rdf:resource":"https://www.dlib.si/details/urn:nbn:si:spr-a30mfzkp"},{"@xml:lang":"sl","#text":"Zdravniški vestnik"}],"dcterms:issued":"2004","dc:creator":["Skok, Marija","Skok, Pavel"],"dc:format":[{"@xml:lang":"sl","#text":"številka:4"},{"@xml:lang":"sl","#text":"letnik:73"},{"@xml:lang":"sl","#text":"str. 181-186"}],"dc:identifier":["ISSN:1318-0347","COBISSID_HOST:1527359","URN:URN:NBN:SI:doc-00UHVAKJ"],"dc:language":"sl","dc:publisher":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"dc:subject":[{"@xml:lang":"sl","#text":"Argon"},{"@xml:lang":"sl","#text":"Coagulation"},{"@xml:lang":"sl","#text":"Endoskopska hemostaza"},{"@xml:lang":"sl","#text":"Hemostasis, endoscopic"},{"@xml:lang":"sl","#text":"Koagulacija"},{"@xml:lang":"sl","#text":"Peptic ulcer hemorrhage"},{"@xml:lang":"sl","#text":"Peptična razjeda, krvavitev"},{"@xml:lang":"sl","#text":"Sclerotherapy"},{"@xml:lang":"sl","#text":"Skleroterapija"}],"dcterms:temporal":{"@rdf:resource":"1929-2026"},"dc:title":{"@xml:lang":"sl","#text":"Peptic ulcer hemorrhage: comparison of efficacy of two methods of endoscopic hemostasis - a prospective study| Krvaveča peptična razjeda: primerjava učinkovitosti dveh metod endoskopske hemostaze - prospektivna raziskava|"},"dc:description":[{"@xml:lang":"sl","#text":"Background. Interventional endoscopy has largely reduced mortality in patients with peptic ulcer hemorrhage. Study aims. To evaluate the efficacy and safety of endoscopic hemostasis with argon plasma coagulation and injection sclerotherapy in bleeding peptic ulcer and determine the mortality of patients in a prospective, controlled study. Patients and methods. The study includes 100 patients with peptic ulcer hemorrhage (male 63, female 37, av. age 57.1 years, SD +/- 16, span 26-80; gastric ulcer 50 patients, duodenal ulcer 50 patients) in the period between 1 Jan. 1999 and 15 May 2000 treated in our institution. The bleeding activity was determined according to Forrest classification. Fifty patients were randomized to receive argon plasma coagulation (ARCO 2000 Electro Surgery unit, group A) and in fifty patients injection sclerotherapy (sclerosing with diluted adrenalin 1:10,000 plus polidocanol 1%, group B) was performed. The groups did not differ with respect to age, sex, site, severity of bleeding, use of NSAID and additional diseases. Results. Clinically and endoscopically diagnosed reebleding occured in 7/50 patients (14%) in group A and in 9/50 patients (18%) in group B; p = 0.78. The majority of reebleding occured within 48 hours after endoscopic hemostasis, group A 4/7 (57.1%), group B 7/9 (77.7%), p = 0.74. Repeated endoscopic hemostasis did not prove successful in 8 patients (group A 3/50, 6%, group B 5/50, 10%), p = 0.71. Seven patients were treated operatively. The total mortality rate was 9% (9/100 patients, group A 4/50, 8%, group B 5/50, 10%), p > 0.05. Only one patient died due to peptic ulcer hemorrhage, other 8 patients died due to concomitant diseases. Conclusions. Argon plasma coagulation seems to be an effective and safe alternative to injection sclerotherapy and other hemostatic modalities in peptic ulcer hemorrhage"},{"@xml:lang":"sl","#text":"Izhodišča. Akutne krvavitve iz zgornje prebavne cevi sodijo med pogosta nujna stanja, s katerimi se srečujemo v urgentni medicini in gastroenterologiji. Peptična razjeda je najpomembnejši vir krvavitev. V Sloveniji je letna incidenca krvaveče peptične razjede 118 bolnikov/100.000 prebivalcev. Bolezen je povezana s pomembno umrljivostjo, še zlasti pri starejših bolnikih s pridruženimi obolenji. Po podatkih iz literature so endoskopske hemostatske metode in zdravljenje v usmerjenih intenzivnih enotah vplivale na zmanjšanje umrljivosti pri teh bolnikih v zadnjem obdobju. Namen raziskave. Namen raziskave je bil ovrednotiti učinkovitost in varnost argonske plazemske koagulacije v primerjavi z injekcijskim sklerozacijskim zdravljenjem pri krvaveči peptični razjedi in ugotoviti umrljivost teh bolnikov v prospektivni, kontrolirani raziskavi. Bolniki in metode. Raziskava vključuje 100 bolnikov s krvavečo peptično razjedo, 63 moških in 37 žensk, povprečne starosti 57,1 leta, SD +/- 16 let, v razponu od 26-80 let. Med njimi je bilo 50 bolnikov z želodčno razjedo in 50 bolnikov z razjedo dvanajstnika, zdravljenih zaradi krvavitve v naši ustanovi v obdobju od 1. januarja 1999 do 15. maja 2000. Vsi bolniki so prvič zakrvaveli zaradi razjede. Ob nujni endoskopski preiskavi je bila aktivnost krvaveče razjede ocenjena v skladu z Forrestovo klasifikacijo. Po randomizaciji smo pri 50 bolnikih opravili endoskopsko hemostazo z argonsko plazemsko koagulacijo (instrument ARCO 2000, skupina A), pri 50 bolnikih pa injekcijsko sklerozacijsko zdravljenje (z razredčenim adrenalinom v razmerju 1:10.000 in 1% polidokanolom, skupina B). Bolnike smo zdravili v enoti internistične intenzivne medicine, kjer so bili hemodinamsko nadzorovani. Prejemali so simptomatsko zdravljenje, vključno s transfuzijami. Skupini bolnikov se nista pomembneje razlikovali glede na starost, spol, aktivnost krvavitve, uporabo nesteroidnih protivnetnih zdravil in pogostost pridruženih obolenj. Rezultati. Klinično in endoskopsko smo potrdili ponovitev krvavitve pri 7/50 bolnikov (14%) v skupini A in pri 9/50 bolnikih pri skupini B (18%), p = 0,78. Večina ponovitev krvavitev je bila v prvih 48 urah po endoskopski hemostazi, v skupini A 4/7 (57,1%), v skupini B 7/9 (77,7%), p = 0,74. S ponovljeno endoskopsko hemostazo nismo bili učinkoviti pri 8 bolnikih (skupina A 3/50, 6%, skupina B 5/50, 10%), p = 0,71. Zaradi neuspešne endoskopske hemostaze smo 7 bolnikov zdravili operativno. Skupna umrljivost vseh naših bolnikov je bila 9% (9/100 bolnikov, skupina A 4/50, 8%, skupina B 5/50, 10%), p > 0,05. Samo en bolnik je umrl zaradi krvaveče peptične razjede, ostalih 8 bolnikov pa zaradi pridruženih bolezni. Zaključki. Argonska plazemska koagulacija sodi med učinkovite, varne in cenovno dostopne metode endoskopske hemostaze pri akutnih krvavitvah iz prebavne cevi. Rezultati raziskave potrjujejo, da je učinkovitost te metode pri krvaveči peptični razjedi primerljiva z injekcijskim zdravljenjem, ki je v Sloveniji med najpogosteje uporabljenimi tehnikami hemostaze. Umrljivost bolnikov s krvavečo peptično razjedo je praviloma odvisna od pridruženih obolenj, ki vplivajo na razvoj zapletov in neuspešnost endoskopskega in/ali operativnega zdravljenja"}],"edm:type":"TEXT","dc:type":[{"@xml:lang":"sl","#text":"znanstveno časopisje"},{"@xml:lang":"en","#text":"journals"},{"@rdf:resource":"http://www.wikidata.org/entity/Q361785"}]},"ore:Aggregation":{"@rdf:about":"http://www.dlib.si/?URN=URN:NBN:SI:DOC-00UHVAKJ","edm:aggregatedCHO":{"@rdf:resource":"URN:NBN:SI:DOC-00UHVAKJ"},"edm:isShownBy":{"@rdf:resource":"http://www.dlib.si/stream/URN:NBN:SI:DOC-00UHVAKJ/26d69268-e3a4-4e5e-810e-ff6fd70d574b/PDF"},"edm:rights":{"@rdf:resource":"http://creativecommons.org/licenses/by-nc/4.0/"},"edm:provider":"Slovenian National E-content Aggregator","edm:intermediateProvider":{"@xml:lang":"en","#text":"National and University Library of Slovenia"},"edm:dataProvider":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"edm:object":{"@rdf:resource":"http://www.dlib.si/streamdb/URN:NBN:SI:DOC-00UHVAKJ/maxi/edm"},"edm:isShownAt":{"@rdf:resource":"http://www.dlib.si/details/URN:NBN:SI:DOC-00UHVAKJ"}}}}