Обґрунтування особливостей хірургічного лікування хвороби Крона

Причини незадовільних результатів лікування хвороби Крону та шляхи їх покращення. Математична модель прогнозування загострень та закономірності розвитку захворювання, інформативні гістоморфологічні маркери. Тактика хірургічного лікування та реабілітація.

Рубрика Медицина
Вид автореферат
Язык украинский
Дата добавления 03.04.2009
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Dissertation for candidate degree (medicine). Speciality: 14.01.03 - surgery. Institute Urgent and Reconstructive surgery named Gusak. Academy of medical sciences of Ukraine, Donetsk, 2008.

The dissertation deals with grounding the features of surgical treatment of Crohn's disease.

As a result of the studies done it must been proved that the indication of radical surgical treatment of CD, besides urgent situation caused by the complication of the main disease, is an increase in androgenic intoxication phenomena, SPOI against the background of large scale conservative therapy employed. palliative operations in a majority of cases are not effective as the involved intestine.

The criteria of the choice of optimal surgical tactics are localization of the lesion severity of disease, the presence and character of complication, acute and chronic course of CD. Operative interferences with simultaneous restoration of intestinal continuity in CD are indicative of ilea-colonic localization of the process, high involvement of the jejunum and a severe course of the process, a chronic course of the process and the presence of scary structures. The objective diagnostic criteria of exacerbation of the process /in the order of there significance/ are a type of operation, leukocyte index of intoxication, pathologic process localization, the state of the patients immunity during the investigation (the number of lymphocytes), the extent of anemia expression, the index of correlation of leukocytes and ESR. On the basis of these findings a computer programmed of prognosis the severity of the course and a possibility of CD exacerbation has been developed. Also very often repeated exacerbations have a clinically similar picture with primary manifestations of disease. A lumen of the created anastomosis must be wide enough in order to avoid its narrowing in possible scarring. In formation of reservoirs it is expedient to reserve ileostomy as a neotherminal part of the small intestine and for the stopping the passage along the intestine till the function of the sphincter normalizes.

Key words: Crohn's disease, surgical treatment.


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