MD668Z - Method for conservative hemostasis of gastroduodenal hemorrhages - Google Patents
Method for conservative hemostasis of gastroduodenal hemorrhagesInfo
- Publication number
- MD668Z MD668Z MDS20130031A MDS20130031A MD668Z MD 668 Z MD668 Z MD 668Z MD S20130031 A MDS20130031 A MD S20130031A MD S20130031 A MDS20130031 A MD S20130031A MD 668 Z MD668 Z MD 668Z
- Authority
- MD
- Moldova
- Prior art keywords
- hemostasis
- conservative
- water
- gastroduodenal
- hemorrhages
- Prior art date
Links
- 230000023597 hemostasis Effects 0.000 title claims abstract description 12
- 238000000034 method Methods 0.000 title claims abstract description 12
- 206010053768 Gastroduodenal haemorrhage Diseases 0.000 title claims abstract description 5
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 10
- TZCXTZWJZNENPQ-UHFFFAOYSA-L barium sulfate Chemical compound [Ba+2].[O-]S([O-])(=O)=O TZCXTZWJZNENPQ-UHFFFAOYSA-L 0.000 claims abstract description 9
- 108090000190 Thrombin Proteins 0.000 claims abstract description 7
- 239000000725 suspension Substances 0.000 claims abstract description 7
- 229960004072 thrombin Drugs 0.000 claims abstract description 7
- 239000000523 sample Substances 0.000 claims abstract description 4
- 210000002784 stomach Anatomy 0.000 claims description 8
- 230000002526 effect on cardiovascular system Effects 0.000 abstract description 4
- 230000007170 pathology Effects 0.000 abstract description 4
- 238000011477 surgical intervention Methods 0.000 abstract description 3
- 239000003814 drug Substances 0.000 abstract description 2
- 238000001356 surgical procedure Methods 0.000 abstract description 2
- 239000000843 powder Substances 0.000 abstract 1
- 208000032843 Hemorrhage Diseases 0.000 description 12
- 238000002360 preparation method Methods 0.000 description 5
- 210000002381 plasma Anatomy 0.000 description 4
- 108010080379 Fibrin Tissue Adhesive Proteins 0.000 description 3
- 238000005406 washing Methods 0.000 description 3
- UXVMQQNJUSDDNG-UHFFFAOYSA-L Calcium chloride Chemical compound [Cl-].[Cl-].[Ca+2] UXVMQQNJUSDDNG-UHFFFAOYSA-L 0.000 description 2
- 208000032456 Hemorrhagic Shock Diseases 0.000 description 2
- 229940122957 Histamine H2 receptor antagonist Drugs 0.000 description 2
- 208000008469 Peptic Ulcer Diseases 0.000 description 2
- 206010049771 Shock haemorrhagic Diseases 0.000 description 2
- 208000007107 Stomach Ulcer Diseases 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- 230000000767 anti-ulcer Effects 0.000 description 2
- 230000000740 bleeding effect Effects 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 239000001110 calcium chloride Substances 0.000 description 2
- 229910001628 calcium chloride Inorganic materials 0.000 description 2
- 230000001684 chronic effect Effects 0.000 description 2
- 230000007547 defect Effects 0.000 description 2
- 238000003745 diagnosis Methods 0.000 description 2
- 208000000718 duodenal ulcer Diseases 0.000 description 2
- 238000011846 endoscopic investigation Methods 0.000 description 2
- 239000004744 fabric Substances 0.000 description 2
- 201000005917 gastric ulcer Diseases 0.000 description 2
- 231100000029 gastro-duodenal ulcer Toxicity 0.000 description 2
- 230000002439 hemostatic effect Effects 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 239000000203 mixture Substances 0.000 description 2
- 208000031225 myocardial ischemia Diseases 0.000 description 2
- 238000002560 therapeutic procedure Methods 0.000 description 2
- PFRQBZFETXBLTP-RCIYGOBDSA-N 2-[(2e,6e,10e,14e,18e)-3,7,11,15,19,23-hexamethyltetracosa-2,6,10,14,18,22-hexaen-1-yl]-3-methyl-1,4-dihydronaphthalene-1,4-dione Chemical compound C1=CC=C2C(=O)C(C/C=C(C)/CC/C=C(C)/CC/C=C(C)/CC/C=C(C)/CC/C=C(C)/CCC=C(C)C)=C(C)C(=O)C2=C1 PFRQBZFETXBLTP-RCIYGOBDSA-N 0.000 description 1
- LRQKBLKVPFOOQJ-UHFFFAOYSA-N 2-aminohexanoic acid Chemical compound CCCCC(N)C(O)=O LRQKBLKVPFOOQJ-UHFFFAOYSA-N 0.000 description 1
- SLXKOJJOQWFEFD-UHFFFAOYSA-N 6-aminohexanoic acid Chemical compound NCCCCCC(O)=O SLXKOJJOQWFEFD-UHFFFAOYSA-N 0.000 description 1
- 108010039627 Aprotinin Proteins 0.000 description 1
- OYPRJOBELJOOCE-UHFFFAOYSA-N Calcium Chemical compound [Ca] OYPRJOBELJOOCE-UHFFFAOYSA-N 0.000 description 1
- HBGOLJKPSFNJSD-UHFFFAOYSA-N Etamsylate Chemical compound CC[NH2+]CC.OC1=CC=C(O)C(S([O-])(=O)=O)=C1 HBGOLJKPSFNJSD-UHFFFAOYSA-N 0.000 description 1
- 108010049003 Fibrinogen Proteins 0.000 description 1
- 102000008946 Fibrinogen Human genes 0.000 description 1
- 208000012671 Gastrointestinal haemorrhages Diseases 0.000 description 1
- HEFNNWSXXWATRW-UHFFFAOYSA-N Ibuprofen Chemical compound CC(C)CC1=CC=C(C(C)C(O)=O)C=C1 HEFNNWSXXWATRW-UHFFFAOYSA-N 0.000 description 1
- 206010061216 Infarction Diseases 0.000 description 1
- 229960002684 aminocaproic acid Drugs 0.000 description 1
- 229940124599 anti-inflammatory drug Drugs 0.000 description 1
- 229960005069 calcium Drugs 0.000 description 1
- 229910052791 calcium Inorganic materials 0.000 description 1
- 239000011575 calcium Substances 0.000 description 1
- 239000004227 calcium gluconate Substances 0.000 description 1
- 229960004494 calcium gluconate Drugs 0.000 description 1
- 235000013927 calcium gluconate Nutrition 0.000 description 1
- NEEHYRZPVYRGPP-UHFFFAOYSA-L calcium;2,3,4,5,6-pentahydroxyhexanoate Chemical compound [Ca+2].OCC(O)C(O)C(O)C(O)C([O-])=O.OCC(O)C(O)C(O)C(O)C([O-])=O NEEHYRZPVYRGPP-UHFFFAOYSA-L 0.000 description 1
- 229960001259 diclofenac Drugs 0.000 description 1
- DCOPUUMXTXDBNB-UHFFFAOYSA-N diclofenac Chemical compound OC(=O)CC1=CC=CC=C1NC1=C(Cl)C=CC=C1Cl DCOPUUMXTXDBNB-UHFFFAOYSA-N 0.000 description 1
- 230000002183 duodenal effect Effects 0.000 description 1
- 210000001198 duodenum Anatomy 0.000 description 1
- 210000003743 erythrocyte Anatomy 0.000 description 1
- 229960004817 etamsylate Drugs 0.000 description 1
- XUFQPHANEAPEMJ-UHFFFAOYSA-N famotidine Chemical compound NC(N)=NC1=NC(CSCCC(N)=NS(N)(=O)=O)=CS1 XUFQPHANEAPEMJ-UHFFFAOYSA-N 0.000 description 1
- 229940012952 fibrinogen Drugs 0.000 description 1
- 210000004051 gastric juice Anatomy 0.000 description 1
- 229960001680 ibuprofen Drugs 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- VMXUWOKSQNHOCA-LCYFTJDESA-N ranitidine Chemical compound [O-][N+](=O)/C=C(/NC)NCCSCC1=CC=C(CN(C)C)O1 VMXUWOKSQNHOCA-LCYFTJDESA-N 0.000 description 1
- 229960000620 ranitidine Drugs 0.000 description 1
- 239000008279 sol Substances 0.000 description 1
- 229940010250 vitamin k 2 Drugs 0.000 description 1
Landscapes
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
Abstract
Description
Invenţia se referă la medicină, în special la chirurgie şi poate fi utilizată pentru hemostaza conservativă a hemoragiilor gastroduodenale, asociate cu patologii cardiovasculare şi cu risc sporit de intervenţii chirurgicale de urgenţă, îndeosebi la persoanele în etate. The invention relates to medicine, especially to surgery, and can be used for the conservative hemostasis of gastroduodenal hemorrhages, associated with cardiovascular pathologies and with increased risk of emergency surgical interventions, especially in the elderly.
Este cunoscută metoda de hemostază conservativă a hemoragiilor gastroduodenale, care include administrarea plasmei native, preparatelor antifibronolitice, preparatelor cu conţinut de calciu, iar local prin sonda nazogastrală se administrează o suspensie ce conţine plasmă liofilizată din sânge, calciu clorid şi acid aminocapronic [1]. The method of conservative hemostasis of gastroduodenal hemorrhages is known, which includes the administration of native plasma, antifibronolytic preparations, calcium-containing preparations, and a suspension containing lyophilized blood plasma, calcium chloride and aminocapronic acid is administered locally through the nasogastric tube [1].
În calitate de cea mai apropiată soluţie este cunoscută metoda de hemostază conservativă a hemoragiilor gastrointestinale, care constă în spălarea stomacului cu apă rece prin sonda nazogastrală în decurs de 7…10 min, administrarea preparatelor de hemostază, a blocatorilor H2-receptorilor şi a adezivului fibrinic. Adezivul fibrinic se administrează peroral de 4…6 ori pe zi în decurs de 3…5 zile. Intravenos se administrează preparate hemostatice: sol. vicasoli 2,0…3,0 ml; sol. etamzilati 2,0…4,0 ml de 3…4 ori pe zi; sol. 10% de calciu clorid 5,0…10,0 ml; se efectuează transfuzii de plasmă 200…300 ml, masă eritrocitară 450…600 ml (cu termenul de păstrare nedepăşit de 3…5 zile). Se administrează H2-blocatori de generaţia II-III; sol. quamatel 0,02 g de 2…3 ori pe zi i/v; tab. ranitidin 0,15 g de 2 ori pe zi. Totodată se administrează şi un adeziv fibrinic, care constă din două componente: primul conţine: fibrinogen 1…1,15 g, calciu gluconat de 10% 20…30 ml, acid aminocapronic de 5% 10…15 ml, vitamina K 2…3 ml, plasmă 100…250 ml, contrical 50000…80000 UI, iar al doilea conţine: apă 500…550 ml şi trombină 3…3,5 g, ambele componente se amestecă nemijlocit înainte de administrare [2]. As the closest solution, the method of conservative hemostasis of gastrointestinal hemorrhages is known, which consists in washing the stomach with cold water through the nasogastric tube within 7...10 min, administration of hemostasis preparations, H2-receptor blockers and fibrin glue . The fibrin glue is administered orally 4...6 times a day for 3...5 days. Hemostatic preparations are administered intravenously: sol. vicasoli 2.0...3.0 ml; ground etamsylate 2.0...4.0 ml 3...4 times a day; ground 10% calcium chloride 5.0...10.0 ml; plasma transfusions 200...300 ml, erythrocyte mass 450...600 ml (with a storage period not exceeding 3...5 days) are performed. II-III generation H2-blockers are administered; ground quamatel 0.02 g 2...3 times a day i/v; table ranitidine 0.15 g 2 times a day. At the same time, a fibrin glue is administered, which consists of two components: the first contains: fibrinogen 1...1.15 g, calcium gluconate 10% 20...30 ml, aminocaproic acid 5% 10...15 ml, vitamin K 2...3 ml, plasma 100...250 ml, contrical 50000...80000 IU, and the second contains: water 500...550 ml and thrombin 3...3.5 g, both components are mixed immediately before administration [2].
Dezavantajele metodelor cunoscute constau în aceea că remediile utilizate per os sunt supuse acţiunii sucului gastric, având un efect hemostatic temporar, totodată sunt foarte costisitoare şi nu sunt accesibile pentru pacienţii în etate, necesită administrare combinată cu preparate medicamentoase cu diverse mecanisme de acţiune, care pot complica starea unor pacienţi cu patologii cardiovasculare concomitente. The disadvantages of the known methods consist in the fact that the remedies used per os are subject to the action of gastric juice, having a temporary hemostatic effect, at the same time they are very expensive and not accessible to elderly patients, they require combined administration with medicinal preparations with various mechanisms of action, which can complicates the condition of some patients with concurrent cardiovascular pathologies.
Problema pe care o soluţionează invenţia solicitată constă în elaborarea unei metode de hemostază de urgenţă în hemoragiile provocate de ulcerele gastro-duodenale, îndeosebi la persoanele în etate cu patologii cardiovasculare concomitente cu risc major pentru intervenţii chirurgicale de urgenţă, care nu sunt costisitoare şi sunt accesibile, pot fi efectuate de urgenţă şi în condiţii de ambulator fără a necesita utilaje suplimentare. The problem that the requested invention solves consists in the development of a method of emergency hemostasis in hemorrhages caused by gastro-duodenal ulcers, especially in elderly people with concomitant cardiovascular pathologies with major risk for emergency surgical interventions, which are not expensive and are accessible , can be performed urgently and in outpatient conditions without requiring additional equipment.
Conform invenţiei, metoda revendicată constă în aceea că se introduce o sondă nazogastrală, prin care se introduce 1…2 L de apă la temperatura de 10…12°C, se efectuează lavajul stomacului timp de 10…15 min, apoi sonda se înlătură şi se administrează per os o suspensie care conţine: 135 g de pulbere de sulfat de bariu, 200 ml de apă şi 1250…3750 UA de trombină. According to the invention, the claimed method consists in inserting a nasogastric tube, through which 1...2 L of water is introduced at a temperature of 10...12°C, the stomach is washed for 10...15 min, then the tube is removed and a suspension containing: 135 g of barium sulfate powder, 200 ml of water and 1250...3750 AU of thrombin is administered orally.
Metoda se efectuează în modul următor. The method is performed as follows.
Pacientul cu hemoragie activă cu localizare în stomac sau duoden se internează, după care se instalează o sondă nazogastrală pentru confirmarea hemoragiei din etajul superior, apoi prin ea se introduce 1…2 L de apă la temperatura de 10…12°C, se efectuează lavajul stomacului timp de 10…15 min, apoi sonda se înlătură şi se administrează per os o suspensie care conţine: 135 g de pulbere de sulfat de bariu, 200 ml de apă şi 1250…3750 UA de trombină. The patient with active bleeding localized in the stomach or duodenum is hospitalized, after which a nasogastric tube is installed to confirm the bleeding from the upper floor, then 1...2 L of water at a temperature of 10...12°C is introduced through it, the lavage is performed stomach for 10...15 min, then the probe is removed and a suspension containing: 135 g of barium sulfate powder, 200 ml of water and 1250...3750 AU of thrombin is administered orally.
Metoda a fost aplicată la 12 pacienţi cu ulcere gastroduodenale complicate cu hemoragie acută obţinându-se rezultate satisfăcătoare. The method was applied to 12 patients with gastroduodenal ulcers complicated with acute hemorrhage, obtaining satisfactory results.
Exemplul 1 Example 1
Pacientul D., 78 ani, a fost internat în secţia reanimare cu diagnosticul: hemoragie acută din ulcer duodenal cronic. Şoc hemoragic gr. II. Cardiopatie ischemică şi stare de postinfarct. ICC gr. III. La investigaţia endoscopică (FEGDS) s-a depistat un defect ulceros pe peretele posterior al bulbului duodenal 1,3x1,0 cm, complicat cu hemoragie activă. Concluzie: ulcer cronic duodenal complicat cu hemoragie activă în pânză (Forest Ib). A fost utilizată metoda revendicată cu instalarea sondei nazogastrale şi spălarea cavităţii stomacului de sânge şi cheaguri. Apoi a fost administrat amestecul de suspensie de sulfat de bariu, şi anume 200 ml, în care s-a adăugat trombină 3750 UA. În urma administrării s-a obţinut hemostaza. Peste 6 ore nu s-au determinat semne de hemoragie. După hemostază, pacientului i s-a administrat o terapie antiulceroasă, iar peste 6 zile a fost externat în stare satisfăcătoare. Patient D., 78 years old, was admitted to the intensive care unit with the diagnosis: acute hemorrhage from chronic duodenal ulcer. Hemorrhagic shock gr. II. Ischemic heart disease and post-infarction condition. ICC gr. III. During the endoscopic investigation (FEGDS), an ulcerous defect was detected on the posterior wall of the duodenal bulb 1.3x1.0 cm, complicated with active hemorrhage. Conclusion: complicated chronic duodenal ulcer with active hemorrhage in the cloth (Forest Ib). The claimed method was used with the installation of the nasogastric tube and washing the stomach cavity of blood and clots. Then the barium sulfate suspension mixture was administered, namely 200 ml, in which thrombin 3750 AU was added. Following the administration, hemostasis was achieved. After 6 hours, no signs of hemorrhage were determined. After hemostasis, the patient was given an antiulcer therapy, and after 6 days he was discharged in satisfactory condition.
Exemplul 2 Example 2
Pacientul A., 70 ani, a fost internat în secţia reanimare cu diagnosticul: hemoragie acută din ulcer gastric acut. Şoc hemoragic gr. II. Cardiopatie ischemică ICC gr. II. Pacientul s-a aflat la tratament în secţia neurologie, administrându-se preparate antiinflamatorii, şi anume Ibuprofen, Diclofenac. La investigaţia endoscopică (FEGDS) s-a depistat un defect ulceros pe curbura mică a stomacului 0,5 x 0,5 cm, complicat cu hemoragie activă în pânză. Concluzie: ulcer gastric acut complicat cu hemoragie Forest Ib. A fost utilizată metoda revendicată cu instalarea sondei nazogastrale şi spălarea cavităţii stomacului de sânge şi cheaguri. Apoi a fost administrat amestecul de suspensie de sulfat de bariu, şi anume 200 ml, în care s-a adăugat trombină 1250 UA. În urma administrării s-a obţinut hemostaza. Peste 6 ore nu s-au determinat semne de hemoragie. După hemostază pacientului i s-a administrat o terapie antiulceroasă, iar peste 6 zile a fost externat în stare satisfăcătoare. Patient A., 70 years old, was admitted to the intensive care unit with the diagnosis: acute hemorrhage from acute gastric ulcer. Hemorrhagic shock gr. II. Ischemic heart disease ICC gr. II. The patient was being treated in the neurology department, being administered anti-inflammatory drugs, namely Ibuprofen, Diclofenac. During the endoscopic investigation (FEGDS), an ulcerous defect was detected on the small curvature of the stomach 0.5 x 0.5 cm, complicated with active hemorrhage in the cloth. Conclusion: acute gastric ulcer complicated with hemorrhage Forest Ib. The claimed method was used with the installation of the nasogastric tube and washing the stomach cavity of blood and clots. Then the mixture of barium sulfate suspension was administered, namely 200 ml, in which thrombin 1250 AU was added. Following the administration, hemostasis was achieved. After 6 hours, no signs of hemorrhage were determined. After hemostasis, the patient was given an antiulcer therapy, and after 6 days he was discharged in satisfactory condition.
1. UA 68469 U 2012.03.26 1. UA 68469 U 2012.03.26
2. MD 1249 G2 1999.06.30 2. MD 1249 G2 1999.06.30
Claims (1)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20130031A MD668Z (en) | 2013-02-22 | 2013-02-22 | Method for conservative hemostasis of gastroduodenal hemorrhages |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20130031A MD668Z (en) | 2013-02-22 | 2013-02-22 | Method for conservative hemostasis of gastroduodenal hemorrhages |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| MD668Y MD668Y (en) | 2013-08-31 |
| MD668Z true MD668Z (en) | 2014-03-31 |
Family
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| MDS20130031A MD668Z (en) | 2013-02-22 | 2013-02-22 | Method for conservative hemostasis of gastroduodenal hemorrhages |
Country Status (1)
| Country | Link |
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| MD (1) | MD668Z (en) |
Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| MD835G2 (en) * | 1996-05-15 | 1998-07-31 | Cicala Evstafii | Method for the bleeding gastroduodenal ulcer treatment |
| MD1249G2 (en) * | 1998-09-30 | 1999-12-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of conservative hemostasis of gastrointestinal hemorhages |
| MD2323G2 (en) * | 2003-06-23 | 2004-06-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Use of S-ethyl isothiouronium bromide (isoturon) as uterotonic preparation for treatment of uterine hemorrhages in case of uterine myoma |
| MD2328G2 (en) * | 2003-07-14 | 2004-07-31 | Константин ЦЫБЫРНЭ | Fibrinous adhesive and use thereof for endoscopic hemostasis of variceal hemorrhages in hepatic cirrhosis |
| MD84Z (en) * | 2009-05-13 | 2010-04-30 | Олег ЗЭНОАГЭ | Method of hemostasis after dental extraction |
| MD344Z (en) * | 2010-11-30 | 2011-11-30 | Георге АНГЕЛИЧ | Method for treating varicose rectal hemorrhages in patients with liver cirrhosis |
| MD372Z (en) * | 2010-11-30 | 2011-12-31 | Георге АНГЕЛИЧ | Endoscopic method of hemostasis of bleeding ulcer in decompensated hepatic cirrhosis |
| UA68469U (en) * | 2011-09-13 | 2012-03-26 | Харьковская Медицинская Академия Последипломного Образования | Method for conservative hemostasis and arrest of bleeding from upper and lower divisions of gastrointestinal tract |
-
2013
- 2013-02-22 MD MDS20130031A patent/MD668Z/en not_active IP Right Cessation
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| MD835G2 (en) * | 1996-05-15 | 1998-07-31 | Cicala Evstafii | Method for the bleeding gastroduodenal ulcer treatment |
| MD1249G2 (en) * | 1998-09-30 | 1999-12-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of conservative hemostasis of gastrointestinal hemorhages |
| MD2323G2 (en) * | 2003-06-23 | 2004-06-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Use of S-ethyl isothiouronium bromide (isoturon) as uterotonic preparation for treatment of uterine hemorrhages in case of uterine myoma |
| MD2328G2 (en) * | 2003-07-14 | 2004-07-31 | Константин ЦЫБЫРНЭ | Fibrinous adhesive and use thereof for endoscopic hemostasis of variceal hemorrhages in hepatic cirrhosis |
| MD84Z (en) * | 2009-05-13 | 2010-04-30 | Олег ЗЭНОАГЭ | Method of hemostasis after dental extraction |
| MD344Z (en) * | 2010-11-30 | 2011-11-30 | Георге АНГЕЛИЧ | Method for treating varicose rectal hemorrhages in patients with liver cirrhosis |
| MD372Z (en) * | 2010-11-30 | 2011-12-31 | Георге АНГЕЛИЧ | Endoscopic method of hemostasis of bleeding ulcer in decompensated hepatic cirrhosis |
| UA68469U (en) * | 2011-09-13 | 2012-03-26 | Харьковская Медицинская Академия Последипломного Образования | Method for conservative hemostasis and arrest of bleeding from upper and lower divisions of gastrointestinal tract |
Non-Patent Citations (1)
| Title |
|---|
| Шестопалов С. Н. Клиника, диагностика и лечение желудочно-кишечного кровотечений у обожженных. Челябинск, 1994, с. 26 * |
Also Published As
| Publication number | Publication date |
|---|---|
| MD668Y (en) | 2013-08-31 |
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