Особливості перебігу та підходи до лікування виразкової хвороби дванадцятипалої кишки при синдромі повернення клініки

Аналіз факторів, які перешкоджають повному вилікуванню пацієнтів на виразкову хворобу дванадцятипалої кишки при синдромі повернення клініки. Дослідження показників загального імунного статусу з особливостями клінічного перебігу виразкової хвороби.

Рубрика Медицина
Вид автореферат
Язык украинский
Дата добавления 29.08.2014
Размер файла 45,8 K

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SUMMARY

Sirotenko A.S. Peculiarities of state and approaches to treatment of peptic duodenal ulcer in patients with syndrome of recurrence of clinic - Manuscript.

Dissertation for graduation Candidate of Medical Sciences degree on specialty 14.01.36 - gastroenterology. - Dniepropetrovsk State Medical Academy, Institute of Gastroenterology, Dniepropetrovsk, 2006.

The dissertation presents the theoretical ground and new decision of scientific-practical task: improvement of diagnostics and treatment of peptic duodenal ulcer (DU) on the background of studying the factors which prevents the full recovery patients and leads to development of syndrome recurrence of clinic (SRC) or to recurrence of DU. There were analyzed the factors of failed treatment and not full recovery of DU in 311 patients with first established DU and in 1208 patients with recurrent DU during from 1 to 20 years before inclusion in the investigation. Among the failed results of treatment there was established the group of patients with SRC. The patients with recurrence of active DU composed the comparing group. There was established that SRC was in 11,7% patients with first established DU and in 25,4% patients who suffered from DU long. Among factors that led to development of SRC in I group and II group the most important factors were stress (93,6 and 82,5%)and dietary disorders (83,9 and 79,6%). In all the patients who were under the observation there were revealed the combination of two (36,9%) and more (63,1%) negative factors. In patients with first established DU there were significant isteroid (p<0,05) signs, and in patients from the II there were revealed hypochondric (p<0,001) and depressive (p<0,05) psychological signs. Besides, the most important factors of recurrent state of DU is contamination of gastric mucosa with Helicobacter pylori (CagA+), hyperpepsinhydria and cholinhydria in combination with decrease of glycoproteins level in gastric contents; decrease of regulatory function of immune system caused by immunosupression, dysballance between cellular and humoral lines of immunity caused by insufficiency of humoral immunity, disorder of functional activity of B-lymphocytes, decompensation of non-specific immune defence, dysballance of neurohumoral factors of regulation, decrease of reserve possibilities of sympatic-adrenal system. There was ground besides to basic therapy the additional usage of psychocorrecting drugs, immunomodulator, drugs for increasing gastric mucosa resistance, drugs for correction of disorders of neurohumoral link of regulation. Key words: peptic duodenal ulcer, syndrome of recurrence of clinic, risk factors, neurohumoral regulation, Helicobacter pylori, immune system.

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