RESUMO
An analysis of observations of 250 patients with different rheumatological diseases has shown that 18% of the patients had ulcer disease with complications. The greatest risk of bleedings and perforations took place during the first year of treatment with nonsteroidal antiinflammatory drugs. The main risk factors of complications were determined. They are: male sex, high parameters of gastric secretion.
Assuntos
Úlcera Duodenal/complicações , Úlcera Péptica Hemorrágica/etiologia , Úlcera Péptica Perfurada/etiologia , Estenose Pilórica/etiologia , Doenças Reumáticas/complicações , Úlcera Gástrica/complicações , Úlcera Duodenal/fisiopatologia , Feminino , Mucosa Gástrica/metabolismo , Humanos , Masculino , Úlcera Péptica Hemorrágica/fisiopatologia , Úlcera Péptica Perfurada/fisiopatologia , Estenose Pilórica/fisiopatologia , Estudos Retrospectivos , Doenças Reumáticas/fisiopatologia , Fatores de Risco , Fatores Sexuais , Úlcera Gástrica/fisiopatologia , Fatores de TempoRESUMO
Since 1986 403 patients have been treated according to the following programme: successive preparation for surgery, the operative intervention chosen individually for each patient, the purposeful medical rehabilitation. Different types of vagotomy with draining operations were performed in 85.6% of the cases, stomach resection--in 14.4% of the patients. The mortality rate was 0%. The indications for various types of vagotomy, stomach resection and different types of draining operations were determined. Rehabilitation of 55% of the patients after the operative treatment took place at the gastroenterological department, the others--at an outpatient department. The indications for rehabilitation, its volume and time were established. The best remote results in the follow-up periods up to five years were obtained after truncal vagotomy and stomach resection. Ulcer recurrences were noted in 3.5% and 5.2% of the cases respectively. Recurrences of the disease were noted in 7.8% after combined vagotomy and in more than 20% after SPV. Nine patients out of 34 with recurrent ulcers were reoperated with good results, the others were successfully treated by conservative therapy.
Assuntos
Úlcera Duodenal/reabilitação , Úlcera Duodenal/cirurgia , Adulto , Úlcera Duodenal/complicações , Feminino , Seguimentos , Gastrectomia/métodos , Gastrectomia/reabilitação , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/reabilitação , Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica Perfurada/reabilitação , Úlcera Péptica Perfurada/cirurgia , Complicações Pós-Operatórias/epidemiologia , Recidiva , Reoperação , Resultado do Tratamento , Vagotomia/métodos , Vagotomia/reabilitaçãoRESUMO
The clinical course of the disease was correlated with the indices characterizing the activity of different components of the immune system in 47 patients with a purulent surgical infection. The investigation has shown the clinical value of immunological tests studied to be not identical. The determination of the concentration of the circulating immune complexes and the migration activity of macrophages is proposed for the prognostic assessment of the course of the disease.
