{"id":40969,"date":"1999-01-01T00:00:00","date_gmt":"1999-01-01T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/control-ambulatorio-de-la-hemorragia-digestiva-alta-no-ligada-a-hipertension-portal\/"},"modified":"1999-01-01T00:00:00","modified_gmt":"1999-01-01T00:00:00","slug":"control-ambulatorio-de-la-hemorragia-digestiva-alta-no-ligada-a-hipertension-portal","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/control-ambulatorio-de-la-hemorragia-digestiva-alta-no-ligada-a-hipertension-portal\/","title":{"rendered":"Control ambulatorio de la hemorragia digestiva alta no ligada a hipertension portal."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Pedro Almela Notari <\/strong><\/h2>\n<p>La hemorragia digestiva alta (hda) es una causa frecuente de hospitalizaci\u00f3n y en muchos casos es autolimitada; en la actualidad hay una serie de criterios clinicoendosc\u00f3picos pron\u00f3sticos.  hipotesis: los pacientes con hda (no ligada a hipertensi\u00f3n portal) de buen pron\u00f3stico pueden ser controlados ambulatoriamente sin incrementar el riesgo.  material y metodos: estudio prospectivo entre 1\/i\/94 y 30\/ix\/97 de pacientes que acuden a urgencias del h. Cl\u00ednico de Valencia. se realiza estudio cl\u00ednico, anal\u00edtico y endosc\u00f3pico en 969 pacientes; se toman como criterios de ingreso la presencia de deterioro hemodin\u00e1mico grave\/severo, la imposibilidad de realizaci\u00f3n de la endoscopia y los estigmas endosc\u00f3picos de mal pron\u00f3stico (resangrado). Del total de pacientes, 201 (20.7 %) se remiten a su domicilio con tratamiento y control posterior en c.E. Gastroenterolog\u00eda y 767 (78 %) pacientes son ingresados.  resultados: los pacientes ambulatorios son mas j\u00f3venes, la hda se manifiesta por melenas o hematemesis no asociadas, presentan menos antecedentes de etilismo y menor comorbilidad. la repercusi\u00f3n hemodin\u00e1mica es menor y las lesiones mas frecuentes en este grupo son: ulcus p\u00e9ptico y erosiones gastroduodenales.  los pacientes ingresados mostraron mayor deterioro hemodin\u00e1mico y las lesiones causantes de la hda fueron, especialmente, el ulcus p\u00e9ptico con estigmas de resangrado mas frecuentemente.  como criterios evolutivos se tomaron la recidiva hemorr\u00e1gica, la necesidad de cirug\u00eda y la mortalidad. La recidiva hemorr\u00e1gica se present\u00f3 en 1 paciente tratado de forma ambulatoria (0.5 %) y en 56 pacientes ingresados (7.3 %); precisaron cirug\u00eda 1 paciente ambulatorio (0.5 %) y 43 pacientes ingresados (5.6 %); fallecieron 3 pacientes ambulatorios (dos de ellos sin recidiva) y 20 ingresados. Se confirma la hip\u00f3tesis emitida.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Control ambulatorio de la hemorragia digestiva alta no ligada a hipertension portal.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Control ambulatorio de la hemorragia digestiva alta no ligada a hipertension portal. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Pedro Almela Notari <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Universitat de val\u00e9ncia (estudi general)<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 01\/01\/1999<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Adolfo Benages Martinez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: eduardo (secretario) Moreno osset <\/li>\n<li>joan Mones xiol (vocal)<\/li>\n<li>gonzalo Mi\u00f1o figuerolas (vocal)<\/li>\n<li>  (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Pedro Almela Notari La hemorragia digestiva alta (hda) es una causa frecuente de hospitalizaci\u00f3n y en muchos [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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