Pavlovskiĭ D P
Ter Arkh. 1986;58(2):20-3.
Eighty-seven patients with complicated patterns of peptic ulcer were examined for different components of the hemostatic system including gastric and duodenal fibrinolysis. It was established that the penetrating ulcer gives rise to hypocoagulemia and accelerates fibrinolysis. The perforating and hemorrhagic ulcers are associated with hypercoagulation, which is a manifestation of the stress response of the body. It is shown that gastric juice and the duodenal content have a hypocoagulation (heparinoid) action on blood and plasma coagulation. Peptic ulcer is marked by high gastric and duodenal fibrinolysis and proteolysis both in the gastric and duodenal mucosa and in the free gastric and duodenal contents as well. It is postulated that all the factors under consideration, which are unfavourable for local hemostasis, may be involved in the pathogenesis of gastroduodenal hemorrhages. The author holds that hemostatics, which suppress fibrinolysis and the acid-peptic factor and stimulate blood coagulation and clot formation in the zone of hemorrhage, may be used locally.
对87例患有复杂型消化性溃疡的患者进行了止血系统不同成分的检查，包括胃和十二指肠的纤维蛋白溶解情况。结果表明，穿透性溃疡会导致低凝血症并加速纤维蛋白溶解。穿孔性和出血性溃疡与高凝状态有关，这是机体应激反应的一种表现。研究显示，胃液和十二指肠内容物对血液及血浆凝固有低凝（类肝素）作用。消化性溃疡的特点是胃和十二指肠黏膜以及游离的胃和十二指肠内容物中均存在较高的胃和十二指肠纤维蛋白溶解及蛋白水解现象。据推测，所有这些不利于局部止血的因素可能都参与了胃十二指肠出血的发病机制。作者认为，可在局部使用能抑制纤维蛋白溶解和酸-消化因子并刺激出血部位血液凝固和血栓形成的止血剂。
