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Journal: Art of Medicine (Vol.4, No. 1)

Publication Date:

Authors : ;

Page : 70-74

Keywords : acute calculous cholecystitis; rehabilitation; patient characteristics;

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Purpose of the study: to characterize patients with acute calculous cholecystitis at the inpatient phase of rehabilitation. Research methods: synthesis and analysis of professional scientific sources; retrospective analysis of 50 medical records of ACC patients undergoing inpatient treatment at the surgery department of the Ivano-Frankivsk Central City Clinical Hospital in 2018. Conclusions. In Ukraine, the incidence of chole-lithiasis is 10% of the population. According to the analy-sis of patients' age structure, it is established that there is a tendency for the incidence of ACC for people of younger age, compared with previous years. Most pa-tients with acute calculous cholecystitis (ACC) are mid-dle-aged (44-60 years) - 38%. The average age of the patients was 57.32 ± 2.03 years. The structure of the main diagnoses was as fol-lows: (ACC) - 24%, acute phlegmonous calculous chole-cystitis AFCC - 40%; acute gangrenous calculous chole-cystitis (AGCC) - 36%. The distribution of complications in ACC was as follows: 38% with local unrestricted serous peritonitis; 10% with local unrestricted serous-fibrous peritonitis; 8% with perivezicular abscess; 4% of patients with local purulent-fibrous peritonitis and 4% of patients with dif-fuse purulent-fibrous peritonitis. In the early postoperative period, the patients had the following complications: acute pancreatitis - 4 cases, exacerbation of chronic pancreatitis - 16, exacerbation of chronic bronchitis - 5, postoperative pneumonia - 3, bleeding from contrapertory - 1, thrombophobia - 7, thrombophobia thrombosis of the lower extremities (sural veins) - 2, exacerbation of peptic ulcer of the duodenum - 5. According to the results of the study, it was found that the length of hospitalization averaged 6.70 ± 0.39 days. Patients with AGCC were 7.78 ± 0.85 days longest in the department and 5.50 ± 0.36 days with ACC. The average time to hospitalization after the onset of the first signs of ACC was 61.48 ± 6.68 h. It should be noted that the longer time has passed since the first symptoms of ACC appeared, the more difficult the complications of the basic diagnosis. Patients with AGCC were the longest in the department. The largest bone mass of patients was of varying degrees of obesity - 36%; the second most prevalent is patients with chronic pancreatitis - 24%; on the third - 20% of patients with coronary heart disease and acute cholestasis of the second stage; in fourth place in number - are patients with grade I hypertension; peptic ulcer of the duodenum - fifth - 12%; with diabetes of the second type on the sixth - 10%; on the seventh - patients with first-degree heart failure (HF) - 8%; on the eighth - patients with COPD(chronic obstructive pulmonary dis-ease )- 7%. Many patients have several concomitant pathologies, usually patients with different degrees of obesity, the higher the degree, the more concomitant diagnoses. Representatives of both sexes are prone to cardiovascular diseases, diseases of the gastrointestinal tract, but there are more women with obesity and type II diabetes. Most men suffer from chronic obstructive pulmonary disease, which is obviously due to the presence of a bad smoking habit. The analysis made it possible to substantiate the creation and implementation of the algorithm of rehabili-tation measures, which should begin during surgery, continue in the early postoperative period and after dis-charge from the hospital.

Last modified: 2020-04-07 20:20:21