Eficacia del tratamiento farmacológico inicial del sangrado digestivo alto en cirróticos según los hallazgos endoscópicos obtenidos
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Este estudio fue enfocado en pacientes cirróticos que cursaron con sangrado digestivo alto, y por sus inclusiones fisiopatológicas y de morbimortalidad se divide este tipo de sangrado en dos grupos: el de origen variceal que se da secundario a la hipertensión portal, y el no variceal como el presentado por ulcera péptica. Metodología: estudio analítico, correlacional, de cohorte transversal, retroprospectivo donde estuvieron incluidos 97 pacientes con cirrosis digestiva que presentaron sangrado digestivo alto en el Hospital Teodoro Maldonado Carbo durante el periodo de Enero 1 del 2019 a Diciembre 31 del 2020. Objetivo: Determinar la eficacia del tratamiento farmacológico inicial del sangrado digestivo alto en cirróticos según los hallazgos endoscópicos obtenidos en el Hospital Teodoro Maldonado Carbo durante el periodo de Enero 1 del 2019 a Diciembre 31 del 2020 Resultados: se demostró que la asociación de los inhibidores de la bomba de protones (IBP), al tratamiento ya conocido en el sangrado digestivo alto en pacientes cirróticos que son los derivados de la somatostatina más antibioticoterapia profilaxis fue justificado ya que en este estudio de 97 pacientes la etiología no variceal fue representativa en 52 pacientes con un 53.61%, teniendo una sensibilidad: 79,59% y especificidad: 94,23% en los hallazgos endoscópicos obtenidos de no sangrado digestivo activo. Conclusión: resaltar la importancia del uso protocolario del IBP como tratamiento farmacológico inicial en el área de emergencia ya que su uso en este estudio tuvo revelo una sensibilidad y especificidad muy representativa para no encontrar sangrado digestivo activo durante la endoscopia diagnostica, así logramos brindarle un tratamiento integro a estos pacientes y reducimos su riesgo de mortalidad.
Palabras clave: cirrosis hepática, sangrado digestivo alto, inhibidores de bomba de protones
This study was focused on cirrhotic patients who had upper gastrointestinal bleeding, and due to its pathophysiological and morbidity-mortality inclusions, this type of bleeding is divided into two groups: variceal bleeding secondary to portal hypertension, and nonvariceal bleeding. the one presented by peptic ulcer. Methodology: analytical, correlational, cross-sectional, retrospective cohort study where 97 patients with digestive cirrhosis who presented upper digestive bleeding were included at Teodoro Maldonado Carbo Hospital during the period from January 1, 2019 to December 31, 2020. Objective: To determine the efficacy of the initial pharmacological treatment of upper digestive bleeding in cirrhotic patients according to the endoscopic findings obtained at the Teodoro Maldonado Carbo Hospital during the period from January 1, 2019 to December 31, 2020. Objective: To determine the efficacy of the initial pharmacological treatment of upper digestive bleeding in cirrhotic patients according to the endoscopic findings obtained at the Teodoro Maldonado Carbo Hospital during the period from January 1, 2019 to December 31, 2020. Results: it was shown that the association of inhibitors of the proton pump (PPI), to the already known treatment in upper gastrointestinal bleeding in cirrhotic patients that are derivatives of somatostatin plus prophylactic antibiotic therapy was justified since in this study of 97 patients the non-variceal etiology was representative in 52 patients with 53.61%, having a sensitivity: 79.59% and specificity: 94.23% in the endoscopic findings obtained from no active digestive bleeding. Conclusion: to highlight the importance of the protocol use of the PPI as initial pharmacological treatment in the emergency area, since its use in this study revealed a very representative sensitivity and specificity for not finding active digestive bleeding during the diagnostic endoscopy, thus we were able to provide a treatment I integrate these patients and reduce their risk of mortality. Keywords: liver cirrhosis, upper gastrointestinal bleeding, proton pump inhibitors
This study was focused on cirrhotic patients who had upper gastrointestinal bleeding, and due to its pathophysiological and morbidity-mortality inclusions, this type of bleeding is divided into two groups: variceal bleeding secondary to portal hypertension, and nonvariceal bleeding. the one presented by peptic ulcer. Methodology: analytical, correlational, cross-sectional, retrospective cohort study where 97 patients with digestive cirrhosis who presented upper digestive bleeding were included at Teodoro Maldonado Carbo Hospital during the period from January 1, 2019 to December 31, 2020. Objective: To determine the efficacy of the initial pharmacological treatment of upper digestive bleeding in cirrhotic patients according to the endoscopic findings obtained at the Teodoro Maldonado Carbo Hospital during the period from January 1, 2019 to December 31, 2020. Objective: To determine the efficacy of the initial pharmacological treatment of upper digestive bleeding in cirrhotic patients according to the endoscopic findings obtained at the Teodoro Maldonado Carbo Hospital during the period from January 1, 2019 to December 31, 2020. Results: it was shown that the association of inhibitors of the proton pump (PPI), to the already known treatment in upper gastrointestinal bleeding in cirrhotic patients that are derivatives of somatostatin plus prophylactic antibiotic therapy was justified since in this study of 97 patients the non-variceal etiology was representative in 52 patients with 53.61%, having a sensitivity: 79.59% and specificity: 94.23% in the endoscopic findings obtained from no active digestive bleeding. Conclusion: to highlight the importance of the protocol use of the PPI as initial pharmacological treatment in the emergency area, since its use in this study revealed a very representative sensitivity and specificity for not finding active digestive bleeding during the diagnostic endoscopy, thus we were able to provide a treatment I integrate these patients and reduce their risk of mortality. Keywords: liver cirrhosis, upper gastrointestinal bleeding, proton pump inhibitors
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Cirrosis hepática, Hemorragia gastrointestinal, Epidemiología analítica, Estudios retrospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador