CHARACTERISTICS OF PATIENTS WITH CHRONIC CALCULOSIS CHOLECYSTITIS AT THE INPATIENT REHABILITATION STAGE
Journal: Art of Medicine (Vol.4, No. 2)Publication Date: 2020-05-26
Authors : N.R. Golod;
Page : 38-41
Keywords : Chronic Calculous Cholecystitis; laparoscopic cholecystectomy; rehabilitation;
Abstract
Purpose of the study. The analysis of treatment of a retrospective group of patients with Chronic Calculous Cholecystitis in early postoperative period was performed. The annual growth of this pathology, which in Ukraine is 10% of the population, forces us to look for new approaches to treatment. The study was conducted as part of the scientific work "Theoretical and methodological foundations of physical therapy of pa-tients after laparoscopic cholecystectomy." Research methods: A retrospective analysis of 50 medical records of patients with CCC who were hos-pitalized in the surgical department of Ivano-Frankivsk Central City Clinical Hospital during 2018. The aim of the study is to characterize patients with Chronic Calculous Cholecystitis at the in-patient stage of rehabilitation in order to search for an improve-ment of the means of restoring body functions at different stages of the postoperative period in patients with housing and communal services after laparoscopic cholecystectomy. When analyzing the age and sex structure of pa-tients, it was found that the proportion of patients of working age (up to 60 years) was 66%, while patients of disabled age group (over 60) were 34%. The largest per-centage of patients was among middle-aged (45-60 years) - 38%; in second place in terms of number of representatives of the elderly (61-75 years) - 34%; in the third - young patients (25-44 years old) - 28%; there were no patients of senile age (75-90 years). The average age of the patients as a whole was 52.34 ± 1.73 years, female patients (86%) (age - 51.91 ± 1.93) years, male patients (14%) (age - (55.00 ± 3, 73). Of the 50 patients, only 5 (10%) were without concomitant somatic pathology, while in 45 (90%) con-comitant somatic pathologies were diagnosed for one concomitant disease in 16 patients (32%), two in 13 pa-tients (26%) , three in 9 (18%), four in 3 patients (6%), five in 2 patients (4%), six in 2 patients (4%). Concomi-tant chronic diseases in patients of both groups were in the stage of compensation but did not constitute a contraindication to surgery. The following clinical symptoms were identified by characteristic clinical manifestations: 70% pain in the right hypochondrium, of varying intensity, intensified with errors after eating fatty, meat, fried foods, alcohol, and physical exertion. Irradiation of pain in the right scapula, interscapular space was observed in 16%, bitter-ness in the mouth was noted by 72% of the examined, nausea was observed in 14%, bloating - 18%. All patients underwent laparoscopic cholecystec-tomy under general anesthesia. The duration of the operation was 53.70 ± 4.13 minutes. At discharge, patients did not receive clear in-formation about the further recovery method. 1. A retrospective analysis of the results of sur-gical treatment of patients with Chronic Calculous Chol-ecystitis showed that in the absence of a rehabilitation complex that is not included in the protocols, the number of complications was 34%, and the hospital stay was 3.76 ± 0.28 days. 2. Unsatisfactory consequences in early postop-erative period are caused by the absence of a physician of physical rehabilitation medicine in a medical institution, a complex of rehabilitation measures in the protocols, and the negative impact of concomitant pathology. 3. The development and strict adherence to a set of rehabilitation measures will further contribute to the quick recovery of the patient, reducing the number of complications and the length of hospital stay.
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