{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:20:36Z","timestamp":1771510836539,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"17","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>Risikofaktoren f\u00fcr eine gastrointestinale Ulkusblutung\u2002Die Helicobacter-pylori-Gastritis (H. pylori-Gastritis) und die Therapie mit nicht steroidalen Antirheumatika (NSAR) sind die wichtigsten Risikofaktoren f\u00fcr die Entstehung eines peptischen Ulkus (PUD) und einer Ulkusblutung. Eine Infektion mit H. pylori erh\u00f6ht das Risiko einer Ulkusblutung bei Patienten mit PUD, die NSAR, Aspirin oder einen anderen Pl\u00e4ttchen-Aggregationshemmer einnehmen. H. pylori-positive Patienten unter kombinierter Pl\u00e4ttchen-Aggregationshemmung tragen das h\u00f6chste Blutungsrisiko. Evidenzbasierte interdisziplin\u00e4re Behandlungsempfehlungen zur sicheren NSAR-Anwendung aus dem Jahr 2020 ber\u00fccksichtigen sowohl das kardiovaskul\u00e4re als auch das gastrointestinale Risikoprofil der einzelnen Patienten. F\u00fcr Patienten mit einem moderaten Risiko f\u00fcr die Entstehung eines PUD wird die Therapiekombination aus NSAR und Protonen-Pumpen-Inhibitoren (PPI) oder eine Monotherapie mit selektiven COX-2-Inhibitoren (COX-2: Cyclooxygenase-2) empfohlen. Patienten mit einem hohen Blutungsrisiko dagegen sollten eine Kombinationstherapie aus selektivem COX-2-Inhibitor und PPI erhalten. Bei Patienten mit einem hohen kardiovaskul\u00e4ren Risiko, bei denen auf eine NSAR-Therapie nicht verzichtet werden kann, werden Naproxen oder Celecoxib empfohlen.<\/jats:p><jats:p>Die Behandlung der gastrointestinalen Ulkusblutung\u2002Die Ulkusblutung geht mit einer erh\u00f6hten Letalit\u00e4t einher. Bei h\u00e4modynamisch stabilen Patienten mit Zeichen einer oberen gastrointestinalen Blutung und erh\u00f6htem Sterberisiko (Glasgow-Blatchford Score \u2265\u200a12) ist die Durchf\u00fchrung einer \u00d6sophago-Gastro-Duodenoskopie (\u00d6GD) nach 6\u201324 Stunden ausreichend, eine Notfall-\u00d6GD (innerhalb der ersten 6 Stunden) verbessert vergleichsweise die 30-Tage-Letalit\u00e4t nicht. Nach erfolgreicher endoskopischer H\u00e4mostase reduziert eine zus\u00e4tzliche prophylaktische angiografische Embolisation das Risiko einer erneuten Blutung nicht.<\/jats:p><jats:p>Die Helicobacter-pylori-Eradikation\u2002Eine erfolgreiche H. pylori-Eradikation reduziert das Risiko f\u00fcr die Entwicklung eines Magenkarzinoms bei Verwandten ersten Grades von Patienten mit Magenkarzinom um 73\u200a%. Bei Patienten mit erfolgreicher endoskopischer Behandlung eines Magenfr\u00fchkarzinoms ist eine H. pylori-Testung mit anschlie\u00dfender Eradikation ebenfalls sinnvoll, da hierdurch die Rate an metachronen Magenkarzinomen halbiert werden konnte. Die Standard-Triple-Therapie zu der H. pylori-Eradikation zeigt aufgrund zunehmender Antibiotikaresistenzen, insbesondere gegen Makrolide, eine nachlassende Wirksamkeit. Dementsprechend wird die Bismut-haltige Quadrupel-Therapie als empirische Standard-Erstlinientherapie empfohlen.<\/jats:p>","DOI":"10.1055\/a-1640-2830","type":"journal-article","created":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T22:30:26Z","timestamp":1661725826000},"page":"1103-1108","source":"Crossref","is-referenced-by-count":2,"title":["Gastroduodenale Ulkuskrankheit und Helicobacter pylori"],"prefix":"10.1055","volume":"147","author":[{"given":"Cornelia","family":"Schneider","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, Hepatologie und Infektiologie am Universit\u00e4tsklinikum Magdeburg."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marino","family":"Venerito","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, Hepatologie und Infektiologie am Universit\u00e4tsklinikum 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