Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2009 Vol. 17 No 3

GENERAL AND SPECIAL SURGERY

I.I. KONAKHOVICH, M.M. SACHEK

EXPEDIENCY SUBSTANTIATION OF THE ERADICATION THERAPY USE IN THE TREATMENT OF PATIENTS WITH ACUTE POISONINGS WITH THE SUBSTANCES OF CORRODING ACTION ON THE BASIS OF CLINICAL MODELING

The research is aimed to estimate clinical efficacy of eradication therapy in the patients with acute poisonings with the substances of corroding action on the basis of “decision tree”. 116 patients with acute poisonings with the substances of corroding action composed the research group. H. pylori diagnostics was made by means of the urease test and histological study. “Decision tree” was modeled; the risk of development of the H. рylori dissemination distant consequences in the stomach mucous membrane was estimated. Eradication application in the patients with acute poisonings with the substances of corroding action contributes to the additional increase of the therapy efficacy: stomach ulcer prevention during 1-year period in 21% of patients and during 2-year period – in 25%; stomach hemorrhage prevention – in 4,7%; stomach cancer prevention – in 2,4% of patients. Eradication application in case of the stomach chemical burns caused by the substances of corroding action in Helicobacter pylori positive patients improves the prognosis: it prevents stomach ulcers development during 1-year period in 30% and during 2-year period in 34% of patients, stomach hemorrhage development – in 3,5%, stomach cancer – in 1% of patients.

Keywords: acute poisonings with the substances of corroding action, Helicobacter pylori, risk of the stomach ulcer, hemorrhage, stomach cancer development
p. 42 - 57 of the original issue
References
  1. Сенцов, В. Г. О мерах по совершенствованию оказания медицинской помощи больным с острыми отравлениями / В. Г. Сенцов, Н. В. Ножкина. – Екатеринбург: изд. Уральского ун-та, 2002. – С. 5.
  2. Лужников, Е. А. Экзотоксикоз при острых эндогенных отравлениях / Е. А. Лужников, Ю. С. Гольдфарб, А. М. Марупов. – Москва: Бином, 2008. – 200 с.
  3. Аруин, Л. И. Морфологическая диагностика болезней желудка и кишечника / Л. И. Аруин, Л. Л. Капулер, В. А. Исаков. – Москва: Триада-Х, 1998. – С. 69-119.
  4. Long-term effects of eradication of Helicobacter pylori on relapse and histology in gastric ulcer patients: a two-year follow-up study / R. Befrits [et al.] // Scand. J. Gastroenterol. – 2004. – Vol. 39, N 11. – P. 1066-1072.
  5. Successful eradication of Helicobacter pylori prevents relapse of peptic ulcer disease / T. Tomita [et al.] // Aliment. Pharmacol. Ther. – 2002. – Vol. 16. Suppl. 2. – P. 204-209.
  6. H. pylori eradication therapy vs. antisecretory non-eradication therapy (with or without long-term maintenance antisecretory therapy) for the prevention of recurrent bleeding from peptic ulcer / J. P. Gisbert [et al.] // Cochrane Database Syst. Rev. – 2004. – Vol. 2. – CD004062.
  7. Helicobacter pylori eradication and gastric ulcer healing—comparison of three pantoprazole-based triple therapies / P. Malfertheiner [et al.] // Aliment. Pharmacol. Ther. – 2003. – Vol. 17, N 9. – P. 125-135.
  8. Клинико-экономический анализ / П. А. Воробьев [и др.]; под общ. ред. П. А. Воробьева. – М.: Ньюдиамед, 2008. – 778 с.
  9. Effect of esomeprazole triple therapy on eradication rates of Helicobacter pylori, gastric ulcer healing and prevention of relapse in gastric ulcer patients / Z. Tulassay [et al.] // Eur. J. Gastroenterol. Hepatol. – 2008. – Vol. 20, N 6. – P. 526-536.
  10. Сравнительнфый анализ эффективности двух схем эрадикации НР на основе омепразола, кларитромицина и амоксициллина у больных язвенной болезнью двенадцатиперстной кишки: результаты рандомизированного двойного-слепого контролируемого исследования / В. А. Исаков [и др.] // Экспериментальная и клиническая гастроэнтерология. – 2003. – № 3. – С. 8-12.
  11. Comparison of sequential and standard triple-drug regimen for Helicobacter pylori eradication: a 14-day, open-label, randomized, prospective, parallel-arm study in adult patients with nonulcer dyspepsia / A. Uygun [et al.] // Clin. Ther. – 2008. – Vol. 30, N 3. – P. 528-534.
  12. Helicobacter pylori eradication as the sole treatment for gastric and duodenal ulcers / P. E. Arkkila [et al.] // J. Gastroenterol. Hepatol. – 2005. – Vol. 17, N 1. – P. 93-101.
  13. Hopkins, R. J. Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review / R. J. Hopkins, L. S. Girardi, E. A. Turney // Gastroenterology. – 1996. – Vol. 110, N 4. – P. 1244-1252.
  14. Figura, N. Helicobacter pylori exotoxins and gastroduodenal diseases associated with cytotoxic strain infection / N. Figura // Aliment. Pharmacol. Ther. – 1996. – Vol. 10. – Suppl. 1. – P. 79-96.
  15. Arkkila, P. E. Eradication of Helicobacter pylori improves the healing rate and reduces the relapse rate of nonbleeding ulcers in patients with bleeding peptic ulcer / P. E. Arkkila, K. Seppдlд, T. U. Kosunen // Am. J. Gastroenterol. – 2003. – Vol. 98, N 10. – P. 2149-2156.
  16. Kuipers, E. J. Review article: exploring the link between Helicobacter pylori and gastric cancer / E. J. Kuipers // Aliment. Pharmacol. Ther. – 1999. – Vol. 13. – Suppl. 1. – P. 3-11.
  17. Correa, P. Human gastric carcinogenesis: a multistep and multifactorial process / P. Correa // Cancer Res. – 1992. – Vol. 52. – P. 6735-6740.
  18. Лапина, Т. Л. Язвенная болезнь желудка и двенадцатиперстной кишки / Т. Л. Лапина // Consilium medicum [Электронный ресурс]. – 2002. – Том 4, № 9. – Режим доступа: http://www.consilium-medicum.com/magazines/cm/medicum/article/14020. – Дата доступа: 11.03.2009.
  19. Лечение и профилактика поражений слизистой оболочки желудочно-кишечного тракта в современной клинической практике: учеб. пособие / под ред. А. Л. Верткина. – Москва, 2007. – С. 47-59.
  20. Тематический выпуск для фармацевтов, провизоров и руководителей медицинских учреждений № 302 // Эксперсс-информация и анализ рынка. – 2009. – № 7. – 52 с.
  21. Основы фармакоэпидемиологического и фармакоэкономического анализа использования лекарственных средств при хронических заболеваниях: учеб.-метод. пособие / И. Н. Кожанова [и др.]; М-во здравоохр. Респ. Беларусь, Бел. мед. академия последиплом. образования. – Минск, 2006. – 38 с.
  22. Assessing the impact of heart failure specialist services on patient populations / G. Lyratzopoulos [et al.] // BMC Health Services Research [Electronic resourse]. – 2004. – Mode of access: www.biomedcentral.com/1472-6963/4/. – Date of access: 10.05.2009.
  23. Флетчер, Р. Клиническая эпидемиология. Основы доказательной медицины: пер. с англ. / Р. Флетчер, С. Флетчер, Э. Вангер. – 3-е изд. – М.: Медиа Сфера, 2004. – 352 с.
  24. Gimmell, I. Population impact of stricter adherence to recommendations for pharmacological and lifestyle interventions over one year in patients with coronary heart disease / I. Gimmell, R. F. Heller, K. Payne // J. Epidemiol. Community Health. – 2005. – Vol. 59. – P. 1041-1046.
  25. Heller, R. F. Implementing guidelines in primary care: can population impact measures help? / R. F. Heller, R. Edwards // BMJ. – 2003. – P. 330-342.
  26. Feng, L. Y. Effects of killing Helicobacter pylori quadruple therapy on peptic ulcer: a randomized double-blind clinical trial / L. Y. Feng, X. X. Yao, S. L. Jiang // World J. Gastroenterol. – 2005. – Vol. 11, N 7. – P. 1083-1086.
  27. Рекомендации международных согласительных документов по профилактике рака желудка и рецидивов гастродуоденальной язвы / С. И. Пиманов [и др.] // [Электронный ресурс]. – Consilium Medicum. – 2008. – Том 10, № 8. – Режим доступа: – Дата доступа: 25.05.2009.
  28. Impact of H. pylori eradication on gastric cancer prevention: endoscopic results of the Japanese intervention trial (JITHP-study), a randomized multi-center trial / D. Saito [et al.] // Gastroenterology. – 2005. – N 128. – P. A-4.
  29. The effect of eradicating Helicobacter pylori on the development of gastric cancer in patients with peptic ulcer disease / S. Take [et al.] // Am. J. Gastroenterol. – 2005. – N 100. – P. 1037-1042.
  30. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial / B. C. Wong [et al.] // JAMA. – 2004. – N 291. – P. 187-194.
Contacts | ©Vitebsk State Medical University, 2007