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PHARMACOEPIDEMIOLOGICAL ANALYSIS OF THE PERFORMED
CONSERVATIVE TREATMENT IN PATIENTS WITH
CHOLELITHIASIS OF THE GERONTOLOGICAL GROUP OF THE
FERGANA VALLEY
Salakhidinov S.Z.
Mamasaliev N.S.
Mamasaliev Z.N.
Usmonov B.U.
Umurzaqov O.T.
Andijan State Medical Institute, Uzbekistan
https://doi.org/10.5281/zenodo.15131035
Relevance.
According to the WHO, in the modern treatment and diagnostic
process of cholelithiasis (CSD) it is important, especially in individuals of the
gerontological group (75-90 years and above), not only to provide scientific
information on a certain type of treatment (surgical or conservative) and clinical
and fundamental recommendations, but also to acquire modern innovative
technologies acceptable for preventive surgery and the ability to use them. For
the advanced development of CSD surgery in the 21st century, it is important to
identify the most susceptible individuals with high or very high risk for this
pathology and their special prevention to ensure the process of early detection,
effective
and
safe
treatment
(with
proper
pharmacovigilance,
pharmacoepidemiological screening) and the prevention of not only CSD itself,
but also formidable complications of cholecystectomy, cholecystostomy,
choledochotomy,
choledochomyotomy
and
transduodenal
sphincteropapillotomy.
The aim of the study
is to study the prevalence, pharmacoepidemiology of
cholelithiasis and its main risk factors among the male and female unorganized
population of the gerontological group of the Fergana Valley to enable
scientifically based planning and optimization of early diagnosis, prevention and
treatment of this disease.
The object of the study
was a contingent of 4,500 individuals of the
gerontological age population, formed using random number tables based on the
nominal electoral lists of men and women in three regions of the Fergana Valley;
as well as 779 patients with cholelithiasis who were undergoing inpatient
treatment in the regional multidisciplinary hospitals of Andijan, Namangan and
Fergana (for VEN analysis).
The subject of the study:
were the results of general clinical and
biochemical
blood
tests,
survey,
physical,
instrumental
and
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pharmacoepidemiological monitoring; as well as the method of "daily nutrition
reproduction" adapted to the peculiarities of Uzbek cuisine.
Research methods.
To solve the set tasks, epidemiological, clinical,
laboratory, biochemical, instrumental, pharmacoepidemiological and statistical
research methods were used, as well as the “daily nutrition reproduction”
method.
Results of the study:
form-coepidemiological analysis of the performed
conservative treatment in patients with cholelithiasis of the gerontological
group of the Fergana Valley.
The analysis showed that conservative treatment was performed in 86.3%
of women and 13.7% of men with cholelithiasis of the gerontological age of the
Fergana Valley [
ꭓ
2 = 463.6; P <0.001; RR = 0.158; 95% CI = 0.125-0.201].
Conservative therapy was mainly carried out with the following groups of
drugs: antihypertensives, antispasmodics, analgesics, antibacterials, enzyme
inhibitors, infusion agents, NSAIDs, anticoagulants and proton inhibitors.
Considering the importance and preventive significance of the issue in
optimizing treatment, pharmacoprophylaxis and pharmacovigilance of
cholelithiasis in individuals of the gerontological group of the Fergana Valley as
a whole, the main principle is observed: “conservative/drug therapy” is
indicated for gerontological patients with cholelithiasis as preoperative
preparation. It is taken into account that drug therapy is indicated for
gerontological patients only in cases where there are no destructive changes in
the wall of the gallbladder, technical jaundice with a high anesthetic risk, when
the patient refuses surgical intervention. Based on medical records/case
histories, the presence of criteria for diagnosing catarrhal and destructive
cholecystitis against the background of cholelithiasis in each geriatric patient
was assessed (S. F. Bagzhenko, 2015):
In addition, for comparison during the analysis, the following was adopted
as the basic (generally accepted, corresponding to the latest clinical
recommendations) therapy: probing and aspiration of gastric contents, the use
of drugs such as antispasmodic solutions, antibacterial drugs, analgesics,
infusion therapy (in a volume of 40 ml per 1 kg of div weight) with crystalloid
solutions and oral litholytic
therapy
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