Particularităţi clinice la pacienţii cu rectocolită ulcero-hemoragică

Abstract

Introducere. Rectocolita ulcero-hemoragică (RCUH), face parte din grupul de boli inflamatorii intestinale, reprezentând o maladie cronică, recidivantă, care în majoritatea cazurilor evoluează cu extinderea procesului inflamator şi apariţia complicaţiilor. Scopul lucrării. Aprecierea particularităţilor clinice la pacienţii cu RCUH. Material şi metode. Au fost supuse analizei 52 foi de observaţie clinică a pacienţilor (26 femei şi 26 bărbaţi), spitalizaţi în secţiile gastroenterologie şi chirurgie, a IMSP SCM "Sfântul Arhanghel Mihail” la care a fost stabilit diagnosticul de RCUH prin efectuarea colonoscopiei. Vârsta medie a pacienţilor a constituit 51,59±17,06 ani. Au fost analizate manifestările clinice, complicaţiile, gradul de activitate al RCUH conform scorului Truelove & Witts. Datele selectate au fost prelucrate utilizând baza de date Excel, iar analiza statistică a fost efectuată aplicând testul t-Student. Rezultate. Manifestările clinice predominante la pacienţii cercetaţi au fost diareea (75,0%), durerile în flancul şi hipocondrul stâng (71,1%), meteorismul abdominal şi garguimentul intestinal (65,3%), rectoragiile (63,4%), scăderea ponderală (30,7%),tenesmele (15,3%) şi artralgiile (1,9%). Forma uşoară a gradul de activitate al RCUH a fost atestată la 22 pacienţi (42,3%), forma moderată - la 10 pacienţi (19,2%) şi forma severă - la 20 de pacienţi (38,4%). Complicaţiile survenite la pacienţii cu RCUH au fost hemoragia digestivă inferioară masivă, care s-a dezvoltat la 3 pacienţi (5,7%), tromboza anorectală - la 1 pacient (1,9%) şi anemia - la 14 pacienţi (26,9%). Concluzii. RCUH evoluează preponderent cu manifestări clinice intestinale şi complicaţii digestive.

Background. Ulcerative colitis (UC) is part of the group of intestinal inflammatory diseases, representing a chronic, relapsing disease, which in most cases evolves with the expansion of the inflammatory process and the appearance of complications. Objective of the study. Appreciation of clinical features in patients with UC. Material and methods. 52 clinical observation sheets of patients (26 women and 26 men), hospitalized in the gastroenterology and surgery departments of the St Arhanghel Mihail Municipal Clinical Hospital in which the diagnosis of UC was established by colonoscopy, were subjected to analysis. The average age of the patients was 51.59±17.06 years. Clinical manifestations, complications, degree of activity of UC according to the Truelove & Witts score were analyzed. The selected data were processed using the Excel database, and the statistical analysis was performed by applying the t-Student test. Results. The predominant clinical manifestations in the investigated patients were diarrhea (75.0%), pain in the flank and left hypochondrium (71.1%), abdominal flatulence and intestinal gargling (65.3%), rectal bleeding (63.4%), decreased weight gain (30.7%), tenesmus (15.3%) and arthralgia (1.9%). The mild form of the degree of activity of UC was attested in 22 patients (42.3%), the moderate form - in 10 patients (19.2%) and the severe form - in 20 patients (38.4%). The complications that occurred in patients with UC were massive lower digestive hemorrhage, which developed in three patients (5.7%), anorectal thrombosis - in one patient (1.9%) and anemia - in 14 patients (26.9%). Conclusions. UC evolves predominantly with clinical manifestations intestinal and digestive complications.