nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»nogr-506Research ArticleОБМЕН ОПЫТОМEXPERIENCE EXCHANGEАНАЛИЗ ПОДХОДОВ К ЛЕЧЕНИЮ ОСЛОЖНЕННОЙ ДИВЕРТИКУЛЯРНОЙ БОЛЕЗНИ В ПРАКТИКЕTHE COMPLICATED DIVERTICULAR DISEASE - TACTICSШтофинС. Г.ShtofinS. G.sshtofin@yandex.ruЧекановМ. Н.ChekanovM. N.noemail@neicon.ruЛёвкинО. Ю.LyovkinO. Yu.noemail@neicon.ruЧекановА. М.ChekanovA. M.noemail@neicon.ruАсатрянА. А.AsatryanA. A.noemail@neicon.ruШумковО. А.ShumkovO. A.noemail@neicon.ruЧикинёвЮ. В.ChikinyovYu. V.noemail@neicon.ruНовосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian Federation2017201120170117881Copyright © Штофин С.Г., Чеканов М.Н., Лёвкин О.Ю., Чеканов А.М., Асатрян А.А., Шумков О.А., Чикинёв Ю.В., 20172017Штофин С.Г., Чеканов М.Н., Лёвкин О.Ю., Чеканов А.М., Асатрян А.А., Шумков О.А., Чикинёв Ю.В.Shtofin S.G., Chekanov M.N., Lyovkin O.Y., Chekanov A.M., Asatryan A.A., Shumkov O.A., Chikinyov Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/506

В клинике кафедры общей хирургии ФГБОУ ВО НГМУ с 2005 по 2014 наблюдались 43 пациента с дивертикулярной болезнью толстой кишки. Осложнения дивертикулярной болезни в виде острого дивертикулита, парадивертикулярных инфильтратов, абсцессов, перфораций, перитонита - 31 больной в возрасте от 24 до 84 лет. Дивертикулярная болезнь, осложненная кровотечением, 12 случаев (все женщины), в возрасте от 63 до 77 лет. Острый дивертикулит встретился у 11 пациентов, парадивертикулярные инфильтраты, абсцессы, перфорации, перитонит у 20. Консервативное лечение у 11 больных было эффективным. Оно включало в себя инфузионную терапию, применение антибиотиков широкого спектра действия, спазмолитиков, питание энтеральными смесями. 20 пациентов были оперированы по экстренным показаниям. В 4 наблюдениях дренирующие операции выполнены из лапаротомного доступа, так как выполнение лапароскопии было невозможно из-за раннее перенесенных открытых операций. Средний возраст больных этой группы составил 64,5 + 8,54 года. Острый дивертикулит развился у них впервые и соответствовал Hinchey III. 8 пациентам были выполнены обструктивные резекции, средний возраст составил 56,10 + 5,43 лет. Умерли 4 пациента из них от прогрессирующих инфекционных осложнений. Рецидивы дивертикулита имеют высокую частоту осложнений. При Hinchey II-III лапароскопический лаваж и дренирование служат альтернативой операции Гартмана.

In the clinic of General surgery Department of Novosibirsk State Medical University from 2005 to 2014 were observed in 43 patients with diverticular disease of the colon. Complications of diverticular disease with acute diverticulitis, paradigmatically infiltrates, abscesses, perforations, peritonitis - 31 patients aged 24 to 84 years. Diverticular disease complicated by bleeding, 12 cases (all women), ranging in age from 63 to 77 years. Acute diverticulitis was found in 11 patients, paradiverticular infiltrates, abscesses, perforation, peritonitis in 20. Conservative treatment in 11 patients was effective. It included infusion therapy, use of broad-spectrum antibiotics, antispasmodics, enteral nutrition mixtures. 20 patients were operated urgent. n 4 cases the draining operations are performed from laparotomy, because laparoscopy was not possible because of the early migrated in open surgery. The average age of the patients in this group was 64.5 + 8,54 years. Acute diverticulitis they have developed for the first time and was consistent with Hinchey III. 8 patients underwent resection of the obstructive, the average age was of 56.10 + 5.43 years. Recurrent diverticulitis have a high complication rate. In Hinchey II-III laparoscopic lavage and drainage are the alternative to Hartmann’s operation.

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The authors declare that there are no conflicts of interest present.