Purpose. Analysis of structure somatic pathology in patients different age groups before planned ophthalmic surgery. Material and methods. Analyzed 1200 medical records patients previously operated in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 3 age groups were formed. The 1st group included 11 patients under age of 40 years (0.9%), the 2nd group – 234 patients from 41 to 60 years (19.5%), the 3rd group – 955 patients over 60 years (79.6%). In each of the groups, the frequency and structure of concomitant somatic pathology, the degree of its compensation were studied. Results. In the 1st group, 54.5% of patients were somatically healthy, 45.5% had a pathology, represented mainly by stage 1 hypertension and type 1 diabetes. All of them were compensated, there were no difficulties in preparing for the operation in this group. In the 2nd group, 90.2% of patients had somatic pathology. The leading positions were occupied by hypertension and type 2 diabetes, the respiratory system pathologies, rheumatic diseases and the carriage of chronic hepatitis B and C viruses were added. Treatment correction at the preoperative stage was required for 2 patients (0.9%), after which the patients were operated. In 3rd group, 100% of patients had somatic pathology. Its structure did not differ much from the 2nd group, but there were also complications such as heart attacks, acute cerebrovascular accidents, complicated diabetes. Correction of therapy was carried out in 61 people (6.4%), 60 of them were successfully operated, one did not appear for hospitalization. Conclusion. Somatic burden increased and degree of compensation for diseases decreased with increasing age of patients. Successful operations are facilitated by individual approach to patient, taking into account the existing pathology and preoperative preparation. Key words: patient's age, somatic burden, hypertension, diabetes mellitus, compensation.
Purpose. Analysis of the frequency and structure of arterial hypertension (AH) among ophthalmic surgical patients, assessment of the adequacy of prescribed antihypertensive therapy. Material and methods. Clinical material is presented by 157 patients with hypertension. Its structure was assessed. Its structure was assessed according to the stage, the degree of increase in the level of blood pressure (BP) and the category of cardiovascular risk. We analyzed the proportion of cases of uncontrolled hypertension, including those with a sudden pronounced individually significant increase in blood pressure without affecting target organs. Results. The prevalence of patients was stage III hypertension (62.4%), grade 3 hypertension (53.5%), with a very high and high risk of cardiovascular complications (73.2 and 20.4%, respectively). 93.6% of patients received antihypertensive therapy, but only 57.1% of them, mostly women (69.1%), regularly took medications and monitored their blood pressure. With a sudden pronounced individually significant increase in blood pressure, we used oral antihypertensive drugs – captopril and nifedipine, which made it possible to achieve a decrease in blood pressure and relief of clinical symptoms in all cases. Conclusion. 33.1% of patients had no hypertension control at the time of hospitalization. The proportion of patients with a sudden pronounced individually significant increase in blood pressure was 12.7%. Typical reasons for loss of control over hypertension were interruptions in taking antihypertensive drugs and high stress levels before surgery. The use of standard dosage captopril and nifedipine was effective in all cases. Key words: arterial hypertension, sudden pronounced individually significant increase in blood pressure, antihypertensive therapy.
Purpose. Evaluation of the frequency of gastroesophageal reflux disease (GERD) in the structure of somatic diseases of patients admitted to ophthalmic surgery, features of the manifestation and difficulties in diagnosing. Material and methods. The analysis of the preoperative state of 1213 patients with pathology of the gastrointestinal tract (GIT) was carried out. The frequency of GERD with typical and extraesophageal manifestations was studied. The assessment of the adequacy and effectiveness of drug therapy is given. Results. Pathology of the gastrointestinal tract in the structure of nosological forms of somatic diseases of patients entering ophthalmic surgery is 5–6%. GERD accounts for 30% of their number. Typical clinical manifestations of GERD occurred in 287 patients (79.1%). Of these, 203 people. (70.7%) were able to compensate for the disease, received adequate therapy with proton pump inhibitors. In 84 patients (29.3%), heartburn and epigastric discomfort persisted. In 76 patients (20.9%) with GERD, its extraesophageal manifestations were revealed. Have 29 people. (38%) they manifested themselves in the form of retrosternal pain. A paroxysmal dry cough, asthma attacks arising after eating, the appearance and aggravation of nocturnal symptoms of bronchial asthma disturbed 35 people (46%). Complaints of burning tongue, hoarseness, soreness when swallowing, sore throat, periodic laryngospasm were observed in 12 patients (16%). Conclusion. GERD takes the leading place among diseases of the upper gastrointestinal tract (more than 30%). About 21% are atypical manifestations of GERD. The most clinically significant among them, limiting the possibility of conducting planned surgical treatment, are cardiological and pulmonary masks. Modern etiopathogenetic treatment of GERD makes it possible to effectively stop the symptoms of the disease, avoid polypharmacy and unreasonable refusal in planned surgical treatment for patients with ophthalmic diseases. Key words: gastroesophageal reflux disease, extraesophageal manifestations, ophthalmic surgery.
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