MICROBIOLOGICAL ASPECTS OF EROSIVE-ULCEROUS LESIONS IN UPPER PART OF THE DIGESTIVE TRACT IN PATIENTS WITH LIVER CIRRHOSIS AND PORTAL HYPERTENSION

R. A. IBADOV, Sh.Kh..KHASHIMOV, L.G. BAJENOV, N.R. GIZATULINA, A.H. BABAJANOV

The Republican Specialized Surgery Centre named after V. Vakhidov, Tashkent, UZBEKISTAN

From the available results we can conclude that more often HP was cultivated from gastric juices (57,5 %), then from biopsy material from cardia (45,0 %) and esophagus (25,0 %). Presence of antibodies to HP in the majority of examined samples (63,3%) is an evidence of the fact that persistence of HP is not indifferent to microorganism and causes its respective reaction.

Study of gastric juices acidity showed that only 22,5% of patients had normal secretion (5-10 mmol/hour), in other 77,5% there was a decrease of gastric secretion. Cultivation assay of the mentioned microorganisms depending on gastric juice acidity level was particularly interesting. This assay shows a tendency of HP exposure while acidity increasing and a reverse tendency related to Candidae. This tendency is especially sharp when testing semination of gastric juices with HP and Candidae.

So high frequency of helicobacteriosis in patients with LC may be caused by various common and local factors: total reduce of resistance to infection in patients with LC, wrong blood circulation in portal system that is resulted in local decrease of mucosa resistance in the gastroduodenal zone. This all cause progressive mucosa atrophy and development of hypo- and achlorhydria.

Pathogenesis of “hepatogenous” erosive-ulcerous process in the stomach of patients with LC and PH lasts for a long time with significant atrophy of the mucosa and, respectively, low secretory activity, accompanied by high semination of HP htat worsens course of the main disease and assists to esophageal-gastric bleeding development.

CHOLUDEXAN IN THE TREATMENT OF CHOLESTASIS SYNDROME

E.G.ISAYEV, R.T.SALIMOVA, R.Y.IBRAHIMOVA, M.A.KHAKIYEVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

Hepatic diseases have a significant place among the causes of disability and mortality throughout the world. In recent decades, hepatology has achieved considerable successes. Especially, in the study of the fine structure and metabolism of the liver, experimental and clinical development of such important syndromes as cholestasis.

The purpose of the investigation: effectiveness of Choludexan (Ursodeoxycholic acid) in the treatment of patients with cholustatic hepatic diseasesds.

Materials and methods: The main group of the study included 24 patients with primary biliary cirrhosis and 24 patients with cholestatic form of alcoholic liver disease - of which 10 patients had cholestatic form of alcoholic hepatitis, and 13 - Cholestatic form of alcoholic hepatitis on the background of alcoholic hepatic cirrhosis. The average age of patients was 49-52 years. The comparative group consisted of 17 patients with cholestatic form of alcoholic liver disease. Patients of the main group were prescribed Choludexan dosed 300 mg per day within 20 weeks. Results: 20 weeks later, patients of the main group that took Choludexan preparation had positive dynamics of clinical-and-laboratory and morphological parameters. All the patients with cholestatic form of alcoholic hepatitis showed improved cenesthesia after treatment: jaundice, itchy skin, fever was fully resolved, recurrent pains in the right upper hypochondrium and hepatomegaly were observed in only 5% of patients of the group. normalization of serum level of GGTP, AP, OB, transaminases, ESR was observed in the patients. In the group of patients with cholestatic form of alcoholic hepatitis on the background of alcoholic cirrhosis with the prescription of Choludexan therapy, fever was completely treated in all patients, significant improvement in cenesthesia and treatment of jaundice – in 80% , signs of asthenia and yellowness of the skin and sclera remained in 20% of patients. Thus, all patients with a cholistic form of alcoholic hepatic disease on the background of a 20-week Choludexan therapy had vegetation of cholestatic forms of alcoholic hepatitis. In the patients of the comparative group, the listed symptoms and indicators were reduced, although not removed, after 20 weeks of observation without the use of Ursodeoxycholic acid on the background of desaxication diuretic therapy.

Conclusions: The positive dynamics of clinical-and-laboratory and morphological parameters in patients with cholestasis syndrome show high effectiveness of Choludexan in such diseases.

Date: 2014-12-28; view: 1053