Lviv clinical bulletin 2014, 3(7): 57-62

https://doi.org/10.25040/lkv2014.03.057

The Effectiveness of Treatment of the Duodenum Peptic Ulcer in the Lviv Region (Retrospective Analysis)

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A. Demydova

Danylo Halytsky Lviv National Medical University

Introduction. The prevalence of H. pylori infection has declined in recent years. However, the processes of population migration offset this difference, and the decline in the rate of distribution of  H. pylori has recently slowed down. In addition, the frequency of unsuccessful eradication has sharply increased in many countries due to the resistance to antibiotics.

In Ukraine, according to the Center of Medical Statistics of Ukraine, the incidence of peptic ulcer over the same period has increased by 38.4% and has no tendency to decrease, and the prevalence of the duodenal peptic ulcer has reached 150 cases per 100 thousand population. Even the intensive introduction of new treatment programs, despite their benefits, does not significantly change the general rates of morbidity and hospitalization of this patient’s contention.

Aim. To find out the effectiveness of treatment of the patients with duodenal peptic ulcer and the need for their retreatment since the introduction of the Maastricht Consensus.

Materials and methods. A retrospective analysis of the efficacy of treatment of the duodenal ulcer of the patients (age – 17-72 years, average age 43.9 ± 1.3 years, 2 191 (63.60%) men and 1 255 (36.40%) women), has been carried out over the 10 years since the introduction of the Maastricht Consensus provisions into the clinical practice.

Results. It was showed that the re-hospitalisation frequency among the patients with duodenal peptic ulcer did not change. The frequency of repeated referrals due to the unsuccessful eradication in this category of patients increased significantly (20.72 % in 1996 vs. 38.82 % in 2006; p < 0.01) as well as the percentage of the reinfected patients (5.80 % in 1996 vs. 24.71 % in 2006). An analysis of the age composition of patients showed that the percentage of reinfecting in individuals aged 60 and over was recorded in 11.50% of cases, at the age of 20-59 (the most able-bodied age) 16.20% of the patients were reinfected. The smallest number of reinfected was recorded in the group of the patients under the age of 19 (5.62%). No difference was noticed in gender composition between the reinfected patients and the patients who requested the treatment repeately after the unsuccessful eradication. In the most working capable part of Lviv region population every third patient with duodenal peptic ulcer requested the repeated treatment during a year.

Conclusions The prevalence among the patients of working age of the duodenal peptic ulcer and the resistance of the helicobacteric infection to antibacterial agents requires a comprehensive study and the adoption of appropriate management decisions in various spheres of life.

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