QON KETISH BILAN ASORATLANGAN 12 BARMOQ ICHAK YARA KASALLIGINI DAVOLASH TAKTIKASI (ADABIYOTLAR SHARHI)

MAXMUDOVA M.O

Oilaviy tibbiyotda xirurgik kasalliklar kafedrasi, Toshkent Davlat Tibbiyot Universiteti, Toshkent, O‘zbekiston

ALIMOV S.U

PhD, Oilaviy tibbiyotda xirurgik kasalliklar kafedrasi, Toshkent Davlat Tibbiyot Universiteti, Toshkent, O‘zbekiston

TAVASHAROV BAXODIR NAZAROVICH

PhD, Oilaviy tibbiyotda xirurgik kasalliklar kafedrasi, Toshkent Davlat Tibbiyot Universiteti, Toshkent, O‘zbekiston

Keywords: o‘n ikki barmoqli ichak yarasi, duodenal yara, gastrointestinal qon ketish, endoskopik gemostaz, Forrest tasnifi, proton pompasi ingibitorlari, Helicobacter pylori, transkateter arterial embolizatsiya, xirurgik davolash, yara kasalligi.


Abstract

 Qon ketish bilan asoratlangan o‘n ikki barmoqli ichak yara kasalligi zamonaviy abdominal xirurgiya va gastroenterologiyaning dolzarb muammolaridan biri hisoblanadi. Ushbu adabiyotlar sharhida duodenal yara qon ketishining epidemiologiyasi, etiopatogenezi, xavf omillari, diagnostikasi va zamonaviy davolash usullari tahlil qilindi. Maqolada H. pylori infeksiyasi, nosteroid yallig‘lanishga qarshi dorilar, antikoagulyant va antiagregant preparatlarning kasallik rivojlanishidagi o‘rni  yoritilgan. Endoskopik diagnostika, Forrest tasnifi, laborator va instrumental tekshiruvlarning prognostik ahamiyati ko‘rib chiqilgan. Shuningdek, endoskopik gemostazning zamonaviy usullari, proton pompasi ingibitorlari terapiyasi, transkateter arterial embolizatsiya hamda jarrohlik davolash usullarining samaradorligi tahlil etilgan. Adabiyotlar tahlili asosida qon ketish bilan asoratlangan duodenal yara kasalligida individual va multidisiplinar yondashuvning muhimligi asoslab berilgan.


References

1. Adilova Z. U., Haydarova Z. T. Problemy xirurgii pri sochetannyx oslozhneniyax yazvennoy bolezni dvenadtsatiperstnoy kishki // European Research: Innovation in Science, Education and Technology. – 2019. – S. 110–112.

2. Alali A. A. An update on the management of non-variceal upper gastrointestinal bleeding // Gastroenterology Report. – 2023. – Vol. 11. – goad011.

3. Avakimyan V. A. i dr. Sochetaniye perforatsii i krovotecheniya pri yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki // Kubanskiy nauchnyy meditsinskiy vestnik. – 2017. – № 6. – S. 7–11.

4. Baracat F., Moura E., Bernardo W., et al. Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials // Surgical Endoscopy. – 2016. – Vol. 30, No. 6. – P. 2155–2168.

5. Baratov N. i dr. Sovremennye tendentsii lecheniya oslozhneniy u patsiyentov s yazvennoy bolezn'yu zheludka i dvenadtsatiperstnoy kishki // International Conference on Medicine & Agriculture. – 2025. – T. 1, № 1. – S. 25–29.

6. Barkun A. N., Martel M., Toubouti Y., et al. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses // Gastrointestinal Endoscopy. – 2009. – Vol. 69, No. 4. – P. 786–799.

7. Beales I. Recent advances in the management of peptic ulcer bleeding // F1000Research. – 2017. – Vol. 6. – Article 1763.

8. Bobokulov A. U. Faktory, sposobstvuyushchiye vozniknoveniyu oslozhnennykh krovotecheniy pri yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki (obzor literatury) // Healthway. – 2025. – T. 1, № 7. – S. 82–86.

9. Chiu H. T., et al. Duodenal ulcer with massive gastrointestinal hemorrhage as an initial manifestation in multiple myeloma with extramedullary disease: a case report // Medicina. – 2022. – Vol. 58, No. 1. – Article 134.

10. Darmon I., et al. Management of bleeding peptic duodenal ulcer refractory to endoscopic treatment: surgery or transcatheter arterial embolization as first-line therapy? A retrospective single-center study and systematic review // European Journal of Trauma and Emergency Surgery. – 2020. – Vol. 46, No. 5. – P. 1025–1035.

11. Djaksymbayev N. B. i dr. Mejdistsiplinarnyy podxod v lechenii yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki, oslozhnennoy krovotecheniyem // Byulleten' nauki i praktiki. – 2025. – T. 11, № 1. – S. 84–96.

12. Gil'fanov A. R. Primeneniye fotodinamicheskoy terapii v kompleksnom lechenii yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki, oslozhnennoy krovotecheniyem // Sovremennye problemy nauki i obrazovaniya. – 2018. – № 5. – S. 54.

13. Gralnek I. M., Stanley A. J., Morris A. J., et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021 // Endoscopy. – 2021. – Vol. 53, No. 3. – P. 300–332.

14. Hao Y., et al. Global epidemiology of peptic ulcer disease: trends in incidence, mortality and aging populations 2000–2024 // Lancet Gastroenterology and Hepatology. – 2025. – Vol. 10, No. 3. – P. 215–229.

15. Hsu-Heng Yen. Forrest Classification for Bleeding Peptic Ulcer: A New Look at the Old Endoscopic Classification // Diagnostics (Basel). – 2022. – Vol. 12, No. 8. – Article 1956.

16. Kadyrov D. M. i dr. Klassifikatsiya sochetannykh oslozhneniy yazvennoy bolezni dvenadtsatiperstnoy kishki, ryad aspektov patogeneza i taktiki xirurgicheskogo lecheniya // Endless Light in Science. – 2023. – № noyabr'. – S. 163–173.

17. Karimov X. Ya., Mavlyanov O. R., Alimov S. U. Rol' i znacheniye sistemy gemostaza u bol'nykh s yazvennoy bolezn'yu zheludka i dvenadtsatiperstnoy kishki, oslozhnennoy krovotecheniyem // Meditsinskiye novosti. – 2021. – № 3 (318). – S. 86– 88.

18. Kazakhstan H. pylori Study Group. A single-center culture-based study of Helicobacter pylori in Kazakhstan with regional meta-analysis of prevalence and antibiotic resistance // Helicobacter. – 2025. – Vol. 30, No. 1. – e13088.

19. Kazakhstan H. pylori Study Group. Regional meta-analysis of Helicobacter pylori prevalence and clarithromycin resistance in Central Asia // Helicobacter. – 2025. – Vol. 30, No. 1. – Suppl. 20. Kodirov F. D. i dr. Sochetaniye penetratsii i piloroduodenal'nogo stenoza pri yazvennoy bolezni dvenadtsatiperstnoy kishki // Vestnik Avitsenny. – 2020. – T. 22, № 2. – S. 311–319.

21. Konovalova O. G., Yashnov A. A., Khanina Yu. S. Sostoyaniye immunnogo statusa u bol'nykh s gastroduodenal'nymi krovotecheniyami pri yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki // IV s'yezd khirurgov Zabaykal'skogo kraya. – 2021. – S. 77–79.

22. Kosachev V. A., Sekeyev A. N., Kosachev A. V. Rol' prognosticheskoy shkaly T. Rockall pri yazvennykh krovotecheniyakh iz lukovitsy dvenadtsatiperstnoy kishki i zalukovichnogo otdela // Izvestiya Rossiyskoy Voyenno-meditsinskoy akademii. – 2019. – T. 3, № S1. – S. 162–165.

23. Krawiec F., et al. Duodenal ulcers are a major cause of gastrointestinal bleeding after cardiac surgery // The Journal of Thoracic and Cardiovascular Surgery. – 2017. – Vol. 154, No. 1. – P. 181–188.

24. Kuneshov K. R. Lecheniye oslozhnennoy yazvennoy bolezni dvenadtsatiperstnoy kishki: sovremennye tendentsii v terapevticheskoy i xirurgicheskoy praktike // Mirovaya nauka. – 2018. – № 1 (10). – S. 43–46.

25. Laine L., Barkun A. N., Saltzman J. R., et al. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding // American Journal of Gastroenterology. – 2021. – Vol. 116, No. 5. – P. 899–917.

26. Larichev A. B., Favstov S. V. Vakuum-terapiya yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki, oslozhnennoy krovotecheniyem // Teoriya i praktika sovremennoy khirurgii. – 2018. – S. 62.

27. Luo Y. R., et al. A case of unexplained duodenal ulcer and massive gastrointestinal bleed // Clinica Chimica Acta. – 2020. – Vol. 506. – P. 188–190.

28. Lyubivyy E. D. i dr. Lecheniye pepticheskoy yazvy gastroenteroanastomoza, oslozhnennoy prodolzhayushchimsya krovotecheniyem. Nablyudeniye iz praktiki // Vestnik Baltiyskogo federal'nogo universiteta im. I. Kanta. – 2021. – № 2. – S. 84–92.

29. Matsuhashi T., et al. Nature and treatment outcomes of bleeding post-bulbar duodenal ulcers // Digestive Endoscopy. – 2022. – Vol. 34, No. 5. – P. 984–993.

30. Mille M., Engelhardt T., Stier A. Bleeding duodenal ulcer: strategies in highrisk ulcers // Visceral Medicine. – 2021. – Vol. 37, No. 1. – P. 52–62.

31. Miyamoto S., Suzuki K., Kinoshita K. Efficiency of a novel gel product for duodenal ulcer bleeding // Digestive Endoscopy. – 2021. – Vol. 33. – P. e63–e64.

32. Mousavi T., Nikfar S., Abdollahi M. The pharmacotherapeutic management of duodenal and gastric ulcers // Expert Opinion on Pharmacotherapy. – 2022. – Vol. 23, No. 1. – P. 63–89.

33. Nagashima K., et al. Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the Japanese evidence-based clinical practice guideline for peptic ulcer disease // JGH Open. – 2018. – Vol. 2, No. 6. – P. 255–261.

34. Nykänen T., et al. Bleeding gastric and duodenal ulcers: case-control study comparing angioembolization and surgery // Scandinavian Journal of Gastroenterology. – 2017. – Vol. 52, No. 5. – P. 523–530.

35. Obloqulov Sh. Sh. i dr. Xirurgicheskiye aspekty lecheniya yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki // Tadqiqotlar. – 2025. – T. 70, № 1. – S. 200– 203.

36. Pashkin K. P. i dr. Nesostoyatel'nost' shvov dvenadtsatiperstnoy kishki posle operatsii po povodu oslozhnennoy duodenal'noy yazvy // Rossiyskiy medikobiologicheskiy vestnik imeni akademika I. P. Pavlova. – 2023. – T. 31, № 1. – S. 147– 154.

37. Patent RF № 2578354. Sposob khirurgicheskogo lecheniya yazvennoy bolezni dvenadtsatiperstnoy kishki, oslozhnennoy krovotecheniyem i penetratsiyey v podzheludochnuyu zhelezu / Kubanskiy gosudarstvennyy meditsinskiy universitet. – Zayavl. 04.03.2015; opubl. 27.03.2016.

38. Ravisankar P., et al. A detailed analysis on acidity and ulcers in esophagus, gastric and duodenal ulcers and management // IOSR Journal of Dental and Medical Sciences. – 2016. – Vol. 15, No. 1. – P. 94–114.

39. Sekiguchi H., et al. Long-term outcomes in patients with post-bulbar ulcer bleeding compared to bulbar ulcer bleeding in the duodenum // Digestion. – 2022. – Vol. 103, No. 2. – P. 126–132.

40. Sigua B. V. i dr. Rekonstruktivnaya operatsiya pri khronicheskoy yazve dvenadtsatiperstnoy kishki, oslozhnennoy krovotecheniyem // Vestnik SZGMU im. I. I. Mechnikova. – 2017. – T. 9, № 2. – S. 131–134.

41. Sukovatykh B. S. i dr. Otdalennye rezul'taty xirurgicheskogo lecheniya yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki, oslozhnennoy perforatsiyey// Chelovek i yego zdorov'ye. – 2017. – № 3. – S. 30–36.

42. Takatori Y., et al. The role of history of gastro-duodenal ulcer in patients with upper gastrointestinal bleeding // Digestive Diseases. – 2018. – Vol. 36, No. 3. – P. 177–181.

43. Tskayev A. Yu., Sarkisyan M. K., Kop'yov M. V. Sochetannyye oslozhneniya yazvennoy bolezni zheludka i dvenadtsatiperstnoy kishki kak dalekaya ot resheniya khirurgicheskaya problema // Vestnik Smolenskoy gosudarstvennoy meditsinskoy akademii. – 2023. – T. 22, № 2. – S. 111–117.

44. Tulkin Z. i dr. Osobennosti xirurgicheskoy taktiki pri perforativnoy yazve dvenadtsatiperstnoy kishki s prognozirovaniyem tyazhesti techeniya peritonita // Zhurnal gumanitarnykh i estestvennykh nauk. – 2024. – № 14 [1]. – S. 117–125.

45. Tursunov B. K. Sochetannyye oslozhneniya yazvy dvenadtsatiperstnoy kishki i ikh khirurgicheskoye lecheniye // Ekonomika i sotsium. – 2021. – № 4-2 (83). – S. 499–503.

46. Ulbricht J., Madea B., Doberentz E. Case report: fatal bleeding from a

duodenal ulcer – Dieulafoy's lesion? // International Journal of Legal Medicine. – 2022. – Vol. 136, No. 1. – P. 203–208.

47. Vacevi A. N. i dr. Pochemu sleduyet otkazat'sya ot operatsii prostogo ushivaniya yazvy dvenadtsatiperstnoy kishki, oslozhnennoy perforatsiyey? // Vestnik khirurgii imeni I. I. Grekova. – 2018. – T. 177, № 3. – S. 41–44.

48. Vakil N. Peptic Ulcer Disease // MSD Manual (Professional Version). – Merck & Co. – 2025.

49. Wade R., South E., Anwer S., et al. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses // Health Technology Assessment. – 2023. – Vol. 27, No. 29. – P. 1–172.

50. Zhyluk A., et al. Persisting bleeding from the duodenal ulcer in patients with

occlusion of the celiac trunk: a case report // Polish Journal of Surgery. – 2021. – Vol. 93, Suppl. – P. 54–58.

51. Zirpe D., et al. Duodenal lipomatosis as a curious cause of upper gastrointestinal bleed: a report with review of literature // Journal of Clinical and Diagnostic Research. – 2016. – Vol. 10, No. 5. – Article PE01.