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НВК - Гастроентерологія - Форум лікарів
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НВК

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Аватар користувача
Світлана
Повідомлень: 46
З нами з: 20 лютого 2015, 00:38
Спеціальність: гастроентерологія
Звідки: Україна
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НВК

Повідомлення#1 » 04 лютого 2017, 17:48

Шановні колеги, потрібна ваша порада.

У відділенні лікується пацієнт 60 років з гістологічно і ендоскопічно підтвердженим НВК. Хворіє 2 роки. Турбують кров'яниста діарея, біль в животі, некротичне ураження шкіри, схудення (з 85 кг до 70 кг ). У хворого є асцит, підвищення трансаміназ. Протромбіновий індекс - 80%, білок 65 г/л, альбумін 30 г/л, анемія 75 г/л.

Хворий отримав курс стероїдних гормонів, але симптоматика без суттєвої позитивної динаміки.

З супутніх хвороб має двобічний ПТФС.

Що би ви порекомендували? Розглядію варіант направлення до хірурга для оперативного лікування.

bonjorno
Повідомлень: 97
З нами з: 19 лютого 2015, 23:14
Спеціальність: хірург
Звідки: Київ
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Re: НВК

Повідомлення#2 » 04 лютого 2017, 19:34

Колектомія. Є багато шансів, що після видалення кишки і шкірні прояви зникнуть.

Аватар користувача
Gaster
Повідомлень: 64
З нами з: 23 лютого 2015, 19:18
Спеціальність: гастроентерологія
Звідки: Україна
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Re: НВК

Повідомлення#3 » 07 лютого 2017, 13:01

А звідки асцит і підвищені трансамінази? У нього цироз? Колектомія можлива, але спочатку треба розібратися з печінкою, щоб не отримати проблем в післяопераційному періоді.

В нього немає склерозуючого холангіту, гепатитів, алкоголізму?

Як впливають препарати вітаміна К на його протромбіновий індекс?

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Світлана
Повідомлень: 46
З нами з: 20 лютого 2015, 00:38
Спеціальність: гастроентерологія
Звідки: Україна
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Re: НВК

Повідомлення#4 » 10 лютого 2017, 20:39


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