RESUMO
An analysis of reporting and statistical data showed the considerable changes in clinical-epidemiological indices of gastric and duodenum ulcer at the period from 1998 to 2012. The prevalence of the disease and the number of primary patients decreased in 2-3 times. The reduction of the rate of perforations and ulcerous bleeding had been observed. However, the authors noted, that a tendency of frequency of occurrence increased and efficacy indices reduced in the last years. The rate of postoperative lethality raised in the cases of perforated ulcer. On this basis, the authors recommend to reconsider the existing opinion about further extension of out-patient treatment of patients with given pathology.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Úlcera Péptica Perfurada , Úlcera Péptica , Adulto , Feminino , Necessidades e Demandas de Serviços de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Úlcera Péptica/complicações , Úlcera Péptica/epidemiologia , Úlcera Péptica/fisiopatologia , Úlcera Péptica/terapia , Úlcera Péptica Perfurada/etiologia , Úlcera Péptica Perfurada/mortalidade , Úlcera Péptica Perfurada/fisiopatologia , Úlcera Péptica Perfurada/cirurgia , Prevalência , Federação Russa/epidemiologia , Análise de SobrevidaRESUMO
Neurohumoral changes were studied in 431 patients with acute intestinal obstruction and in experiments in 165 small laboratory animals with the model of small intestine ileus. The results were obtained on the basis of estimation of the concentration of catecholamines, acetylcholine-like substances, serotonine, histamine, their metabolism products in blood plasma and of the cardiointervalography data. The neurohumoral changes were shown to appear as early as the initial stage of the disease and to be progressing when the disease period became longer. The prevailing sympathetic activity was dependent on the decreased acetylcholine-like substances in blood plasma and tissues. The serotonine and histamine metabolism changed depending on the stage of the disease.
Assuntos
Obstrução Intestinal/fisiopatologia , Obstrução Intestinal/cirurgia , Intestino Delgado , Neurotransmissores/sangue , Doença Aguda , Animais , Catecolaminas/sangue , Catecolaminas/metabolismo , Modelos Animais de Doenças , Histamina/sangue , Histamina/metabolismo , Homeostase , Humanos , Obstrução Intestinal/sangue , Obstrução Intestinal/metabolismo , Neurotransmissores/metabolismo , Ratos , Serotonina/sangue , Serotonina/metabolismo , Sistema Nervoso Simpático/fisiopatologia , Fatores de TempoRESUMO
The structure of endogenic intoxication by products of the intermediate metabolism was studied in 32 patients with intestinal obstruction. The leading components of the endogenic intoxication are: acetone, propionic aldehyde and ethanol. In cases of a complicated course of the intestinal obstruction the operative treatment by traditional therapy in the postoperative period proved to be insufficient. Sessions of the intravascular laser irradiation of blood reducing the concentration of acetone and propionic aldehyde were performed in 19 patients without any changes in the concentration of ethanol.
