Annotation. According to many researchers, non-alcoholic fatty liver disease as an independent disease is underestimated by a large percentage of both patients and physicians. Asymptomatic course, lack of specific complaints leads to the fact that non-alcoholic fatty liver disease is detected by chance on the basis of the detected increase in transaminases or hepatomegaly, which is detected during examination for other pathologies. The high prevalence of the disease, as well as the increase in cardiovascular risk and the risk of hepatocellular carcinoma in non-alcoholic fatty liver disease requires the search for simple and reliable methods of detecting this pathology. We searched for studies that study the diagnostic accuracy of various methods for diagnosing nonalcoholic fatty liver disease and differentiated approaches to their use in scientometric databases PubMED/MEDLINE, EMBASE and the Cochrane Library. The use of the gold standard of diagnosis, namely, liver biopsy is limited by its invasive nature and high cost. The new concept of metabolically associated liver disease and the criteria for its diagnosis allow clinicians to identify more patients at risk of adverse outcomes in clinical practice. The most common and minimally sufficient is the ultrasound examination of the liver with elastography, which allows to assess both the indicators of steatosis and the degree of fibrosis. The diagnostic scales FLI, NAFLD liver fat score, NAFLD liver fibrosis score, APRI, FIB4 and fibromax test remain relevant for the diagnosis of fatty liver disease. Anthropometric diagnostic tests for screening diagnosis of non-alcoholic fatty liver disease are still relevant. Research is currently being conducted to study the epidemiology and mechanisms of development, which will reveal epidemiological and pathogenetic differences between metabolic associated fatty liver disease and non-alcoholic fatty liver disease, which will serve as a step towards the introduction of new diagnostic, prognostic and therapeutic measures.
The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р<0.05), stay in hospital – 3.3 times (р=0.002). There were no fatal outcomes. Before and after operation antirelapse antiparasitic therapy with albendazole (Vormil) was performed in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was calculated at a rate of 15 mg/kg/day. There were 2 (2.8%) cases of relapse, there was no mortality.
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