EFFICIENCY OF PANTOPROSOL (CONTROLOCK) IN THE TREATMENT OF GASTRODUODENAL BLEEDINGS FROM ESOPHAGEAL AND GASTRIC VARICES

O.D. DAYIRBEKOV, N.A. ZHANTALINOVA, I.L. MENSHIKOVA, S.M. ABUOV,

E.Sh. BAIBEKOV

Kazakhstan National Medical University named after S.D. Asfendiyarov,

Almaty, KAZAKHSTAN

Introduction: A specially complex group of causative agents of gastroduodenal bleeding are patients with bleeding from esophageal and gastric varices. Lethality during the first bleeding reaches 50%, and recurrence rate constitutes 50 - 90% [Borisov A.E. et al., 2006].

Materials and methods of study: We examined 30 patients treated for bleeding from esophageal and gastric varices at the age from 25 to 78 years. 56.7% of them were men, 43.3% - women - 43.3%. The patients were divided into 2 groups: 15 – were given 80 mg of pantoprozol daily within 5 days, 15 - 40 mg of famotidine daily, within 7 days. The criteria for evaluation of the effectiveness of treatment included: recurrent hemorrhage, need for endoscopic hemostasis or surgery.

Results: Taking into consideration, that the starting point of bleeding is portal crisis and the effect of acid-peptic factor in the treatment complex of this group of patients, along with drugs reducing portal pressure (β- adrenergic blockers, octreotide) there was used pantoprosol. In addition, the use of this drug was considered possible in the hepatorenal failure, which was observed in 19 (63.3%) patients. And due to tje fact that pantoprosol is safer than other proton pump inhibitors due to minimal interaction with main metabolic systems of the liver. Recurrent bleeding was observed on 3-4^th days after treatment in the 1^st group (pantoprosol) in 3 (20%) patients. Of them, 1 patient (group C acc. to Child-Pugh) was admitted again with bleeding 2 weeks after discharge. Emergency surgery was carried out in 1 (6.7%) patient due to the recurrent bleeding and in 1 case - repeated endoscopic ligation of esophageal varices. No fatal outcomes were observed in this group of patients. In the 2^nd group (famotidine), recurrence was observed in 9 (60%) patients. 5 (33.3%) patients were conducted surgical operation and 3 were performed endoscopic hemostasis. Here it should be noted hepatic failure exacerbated by recurrent bleeding was the reason of death in 7 (15.2%) patients with bleeding from esophageal varices.

Conclusion: Thus, the use of pantoprosol (controlock) turned out to be a quite effective drug in bleedings from esophageal and gastric varices.

Date: 2014-12-28; view: 888