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Title: Предоперационная подготовка и реабилитация больных неспецифическим язвенным колитом
Other Titles: Передопераційна підготовка та реабілітація хворих на неспецифічний виразковий коліт
Preoperative Preparation and Rehabilitation with Nonspecific Ulcerative Colitis
Authors: Дудченко, Максим Андрійович
Дудченко, Максим Андреевич
Dudchenko, M.
Issue Date: 2013
Publisher: Вищий державний навчальний заклад України «Українська медична стоматологічна академія»
Citation: Предоперационная подготовка и реабилитация больных неспецифическим язвенным колитом | М.А.Дудченко // Вісник проблем біології і медицини. - 2013. Т.2, Вип.1. - С.138 - 141.
Abstract: Дослідження проведено на ЗО хворих НВК. Встановлено, що це захворювання має інфекційне аутоімуноагресивне походження, про що свідчить ефективна етіопатогенетичнатерапія, яка включає: маса- лазік, метронідазоя, преднізолон; в м ікро клізмах: дипромак, ретінол, токоферол, гідрокортізон, лідокаїнта ін., та парентерально-дезінтоксикаційна терапія. Клініко-ендоскопічна ремісія наступила на 6-8 днів раніше порівняно з хворими, які лікувались за стандартною методикою ; Исследование проведено на 30 больных неспецифическим язвенным колитом (НЯК). Установлено, что заболевание имеет инфекционно-аутоагрессивное происхождение, о чем свидетельствует эффективность этиопатогенетической терапии, которая включает: масолазин, метронидазол, преднизо- лон (внутривенный введение); в микроклизмах: дипромак, ретинол, токоферол, гидрокортизон, лидокаин, эхинацея и парентеральная дезинтоксикационная терапия. Клинико-эндоскопическая ремиссия наступает на 6-8 дней раньше по сравнению слепившимся по стандартной методике, что говорите явном преимуществе кашей схемы предоперационной подготовки и реабилитации больных НЯК ; Treatment of patients with nonspecific ulcerative colitis (NUC) is of considerable difficulties and depends on the severity of course and occurrence of complications of both local and general character The purpose of the paper was the optimization of conservative NUC therapy tactics with its use during the preoperative preparation and rehabilitation of postsurgical patients. The research has been carried out on 30 patients with nonspecific ulcerative colitis (NUC). The patients were divided into 2 groups, 15 persons each. The first group was examined and received treatment, respectively, according to standard procedure with use of prednisolone internally 40 mg per day, sulfasalazone internally 2 mg per day, microclyster, with hydrocortisone 125 mg per day. The sympatholytics were used, if necessary. The second group received treatment according to procedure that has been elaborated by us: regimen 2, diet 4, per os: masalazine 1 g, prednisolone 20 mg, metronidazole 200 mg, microclyster with dipromac 50 mg, suggested by us (patent for the invention # 95052208 from 25, 12. 1996), which components are: corn oil, propolis, dimethyl sulfoxide, retinol and tocopherol, supplement to the mixture of hydrocortisone (125 mg), lidocainum (400 mg), Echinacea (120 mg): parenteral drop-by-drop introduction of solutions: glucose, isotonic solution, sodium chloride with ascorbic acid, Ringer’s solution. It has been determined that the disease is of the infectious- autoaggressive origin, proved by the effectiveness of etiopathogenetic therapy, which includes the following: masaiazine, metronidazole, prednisolone (intravenous introduction); in the micro clysters: dipromac, retinol, tocopherol, hydrocortisone, lidocainum, Echinacea and parenteral disintoxication therapy. Clinical- endoscopic remission is observed on 6-8 days earlier as compared with patients that were treated according to standard procedure, indicating the clear advantage of our regimen of preoperative preparation and rehabilitation of patients with NUC. The results of the research and their discussion, it has been determined that under the influence of treatment the patient with NUC of medium degree of severity obtained the clinical- endoscopic remission with normalization of laboratory blood values and general condition, allowing to discharge 100 % with considerable improvement (the second group) and 73. 4% (the first group). The patients have been recommended to continue rehabilitation in the ambulatory- polyclinic conditions, using masaiazine orotherdrugs of this group (1 gram per day), prednisolone (10 mg 2 days per week), aevit with ascorbic acid or triovit (1 capsule 3 times a day during 2 months) against the background of sparing regime and light diet, it is noticeable that even under the minor expression of disease it is necessary to take complete examination and antirecurrent treatment, using prednisolone, masaiazine and microclysters with the mixture, specified above, under the regular medical check-up physician’s supervision. NUC is the severe disease of the large bowels, which is based on the infectious- autoimmune aggression. The conservative therapy should be the basic treatment mode, which should include, correspondingly considering the severity and length of disease, the following: bed rest, dietotherapy, which include agents of antibacterial, anti-inflammatory, anti-oxidant, immunopotentiating and sedative action, disintoxication therapy with their internal rectal and parenteral introduction. Dipromac together with lidocainum, hydrocortisone and other drugs should be prescribed as symptomatic therapy. The perspectives of further researches, carried out with regard of this concept, taking into account that the disease is little investigated, as well as low effectiveness of conservative treatment, we consider topical, In terms of studying the: etiology, pathogenesis, enhancement of diagnostics and development of the most effective methods of treatment, considering the etiopathogenesis of NUC. From the surgical point of viewwe considerthe radical colectomy as the surgery, leading to complete invalidization of the patient, due to which all efforts should be directed onto the practicing of procedures of “smooth” resection of iarge bowels, using endovideolaparoscopic facilities and electrosurgery
Keywords: неспецифічний виразковий коліт,
неспецифический язвенный колит
nonspecific ulcerative colitis
Appears in Collections:Наукові праці. Кафедра внутрішньої медицини № 1

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