Profilaktik tibbiyot va salomlatlik
–
Профилактическая
медицина
и
здоровье
–
Preventive Medicine
and Health
Journal home page:
https://inscience.uz/index.php/preventive-medicine
Statistical analysis of the
“City Clinical Hospital № 7”
of
Almaty by methods of treating patients hospitalized with
intestinal insufficiency in the period from 2015 to 2021
Kerim BOLTIRIKOV
1
, Zhanerke SERKEBAYEVA
2
, Nargyz SADYKOVA
3
,
Marlen Zhetpisbay
4
, Nuray ZHUZTAY
5
, Akerke ESKERMES
6
,
Zhuldyz ANDASSOVA
7
, Nargiza NASSYROVA
8
, Nariman DOSZHANOV
9
Asfendiyarov Kazakh Medical National University
ARTICLE INFO
ABSTRACT
Article history:
Received September 2022
Received in revised form
10 October 2022
Accepted 25 November 2022
Available online
15 December 2022
Purpose:
conducting a statistical analysis of treatment
methods for patients hospitalized with intestinal insufficiency
hospitalized in the “City Clinical Hospital № 7” of Almaty from
2015 to 2021. Materials and methods: we conducted a
retrospective analysis of 161016 patients aged 21 to 90 years in
the department of surgery-
1 of the City Clinical Hospital № 7 of
Almaty by the continuous test method. The study was conducted
as a comparative statistical analysis from 2015 to 2021.
The results:
the study showed that the pandemic period of
2020 revealed the maximum intestinal growth and generally
observed accelerated intestinal growth. According to the age
category, patients aged 35 to 60 years are prone to this disease.
Conclusions:
according to the results of the study of the
total number of patients, we concluded that with a pandemic in
2020, there was the maximum increase in the incidence over
the past 6 years. The disease is common among young people.
Keywords:
statistics,
intestinal instability,
pandemic,
therapy,
adhesion,
surgery.
1
Intern doctor of seventh year in
NAO “Asfendiyarov Kazakh Medical National University”,
E-mail: boltirikov.kerim@gmail.com.
2
Intern doctor of seventh year in NAO “Asfendiyarov Kazakh Medical National University”,
E-mail: jayserkebaeva@gmail.com.
3
Intern doctor of seventh year in NAO “Asfendiyarov Kazakh Medical National University”, E
-mail: nako.sadyk@mail.ru.
4
Intern doctor of seventh year in NAO “Asfendiyarov Kazakh Medical National University”, E
-mail: marlen_1998@list.ru.
5
Intern doctor of seventh year in NAO “Asfendiyarov Kazakh
Medical National University”, E
-mail: nuraykahokage@gmail.com.
6
Intern doctor of seventh year in NAO “Asfendiyarov Kazakh Medical National University”,
E-mail: akerke1997yeskermes@gmail.com.
7
Intern doctor of seventh year in NAO “Asfendiyarov Kazakh Medical National University”, E
-mail: andasova2015@mail.ru.
8
Lecturer, Asfendiyarov Kazakh National Medical University, Kazakhstan, Almaty.
E-mail: nassyrova.n94@gmail.com.
9
Assistant of "Surgery-1" department, City Clinical Hospital No. 7,
NAO “Asfendiyarov Kazakh Medical National University”
,
Almaty, Kazakhstan
Profilaktik tibbiyot va salomlatlik
–
Профилактическая медицина и здоровье–
Preventive Medicine and Health
Issue
–
1
№
1 (2022) / ISSN 2181-3663
101
2181-3663
/©
2022 in Science LLC.
https://doi.org/10.47689/2181-3663-vol1-iss1-pp100
This is an open-access article under the Attribution 4.0 International
(CC BY 4.0) license (
https://creativecommons.org/licenses/by/4.0/deed.ru
Статистический анализ методов лечения больных,
госпитализированных с кишечной непроходимостью
в «Городскую клиническую больницу №7» г.
Алматы
в период 2015–2021 гг.
АННОТАЦИЯ
Ключевые слова:
статистика,
кишечная
непроходимость,
пандемия,
терапия,
спайки,
хирургия.
Цель:
провести исследования статистического анализа
методов лечения больных, госпитализированных с
кишечной непроходимостью в «Городской клинической
больнице №7» г. Алматы в период 2015–2021 гг.
Материалы
и
методы:
нами
был
проведен
ретроспективный анализ 161 016 поступивших больных, в
отделение «Хирургия
-
1» ГКБ №7 г. Алматы, методом
сплошной выборки в возрастном диапазоне от 21 до 90 лет.
Исследование
проводилось
как
сравнительный
статистический анализ в период с 2015 по 2021 года.
Результаты: в результате исследования мы выявили, что
период пандемии 2020 году был максимальный рост
спаечной
непроходимости
кишечника
и
видим
прогрессивный рост кишечной непроходимости в целом.
По возрастной категории более подвержены к данному
заболеванию пациенты от 35 до 60 лет.
Выводы:
по проведенному результату исследования от
общего числа пациентов, приходим к выводу что в период
пандемии за 2020 год был максимальный рост
заболеваемости за последние 6 лет. Заболеваемость все
чаще происходит у лиц молодого возраста.
INTRODUCTION
Emergency intestinal insufficiency (EII) is a syndromic complication caused by benign
tumor and malignant tumors occurring in abdominal surgery, as well as non-cancer etiology
[1, 2].
In 1926, Berkeley Moynihans stated: “When surgeons must deal with in
testinal
insufficiency, they have to face disaster. It can usually happen with patients in good health,
men or women in the prime of life, they experience sudden unbearable pain in the stomach
without any warning...” [3].
If treatment is ineffective, it can lead to high mortality. Also, in turn, timely diagnosis of
the disease leads to a good result, which indicates that intestinal insufficiency is one of the
most emergency and dangerous human cases [4].
Today, the statistics of Europe and Asia are similar to the situation in Kazakhstan. It
should also be noted that various interventions (surgery) in the abdominal cavity leading to an
increase in the number of patients with adhesive forms, which, according to statistics, is from
2 to 12% [5, 6].
Profilaktik tibbiyot va salomlatlik
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Профилактическая медицина и здоровье–
Preventive Medicine and Health
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If we take statistics over the past 25 years, then the frequency of EII in adhesive disease
will change. For example, among all inpatients, acute intestinal failure was detected in 51% of
patients. As a result, the treatment was divided into surgical and medical treatment, 83% of
patients received surgical treatment, and the rest received medical care [6].
Intestinal current fluidity is 4/5 (80%) of all intestinal liquidity caused by intestinal
adenocarcinoma (the most common cause).
The diagnosis of intestinal insufficiency should be determined using diagnostic
measures, for example, computed tomography of the abdominal cavity and hip organs.
Diagnostic findings include expansion and collapse of intestinal loops, proximal obstruction,
and large levels of air and liquid. [6, 7]
Despite improvements in treatment and diagnosis during the EII period, mortality in
the UK ranges from 10-30% [5, 6].
According to the morphological functional classification, EII is divided into dynamic and
mechanical intestinal liquidity [7, 8, 9].
Dynamic intestinal insufficiency is divided into spastic and paralytic, and occurs in 3/20
patients. Drug action leads to an increase in motor dysfunction of the intestine and as a result,
forms spastic resistance.
Paralytic intestinal obstructure is characterized by inflammation of the common
intestine or local focus (appendicitis, cholcystitis, chronic pancreatitis), as well as an increase
in gestagens as part of surgical operations and hormonal growth, which reduces the overall
intestinal tone [4, 5, 7].
Operational mechanical liquidity ranges from 85 to 97%. This type of resistance is
divided into obstructive, strangulation mixed and root. Coprostasis, helmintic invasion,
intestinal tumors may be one of the causes of obstructive wasting. As for the strangulation
obstructure, it is characterized by an intestinal twisting, intestinal repulsion, internal
compression, and hook, most often accompanied by compression of mesenteric vessels and
nerves, leading to necrosis and perforation of the intestine. The set of strangulatory and
obstructive instability is characterized by combined intestinal liquidity. One of the factors of
mixed IO is adhesive abdominal disease and invagination. According to the level of intestinal
liquidity, small intestinal (high and low) and current resistance are classified [5, 7].
Intestinal insufficiency by the level of obstruction, which, in turn, can be high and low,
can be intestinal attenuation as well. [10].
PURPOSE:
In the clinical database of the
С
ity
Сlinical Hospital № 7 of the city of Almaty, the
identification of the satiety of treatment methods among patients hospitalized from 2015 to
2021 with a diagnosis of acute intestinal insufficiency and the statistical analysis of the data
obtained.
METHOD AND MATERIAL
We conducted a retrospective analysis of the history of diseases of patients hospitalized
in the department of surgery during the period from 2015 to 2021 using the method of
continuous selection. The age of the envisaged patients is from 21 to 90 years. The study was
conducted as comparative statistical analysis. We considered the frequency of encounters, age
characteristics, treatment routes, the development of acute intestinal insufficiency,
progressive or regressive.
On a basic basis, we took into account the period of admission of patients to the
hospital, the time they took treatment measures and the last discharge.
Profilaktik tibbiyot va salomlatlik
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Graph 1. Statistics of admitted patients with intestinal insufficiency (2015
–
2021)
We analyzed the increase in the number of patients for 2015
–
2021 (graph 1), in order
to prove the progressiveness of intestinal insufficiency.
Graph 2. Linear analysis graph of operative intestinal insufficiency (2015
–
2021)
Due to the change in the age level in physiological development, we considered in
which most young people EII may occur more often, according to the data of patients admitted
to the surgery-1 department of the hospital (graph 2).
Profilaktik tibbiyot va salomlatlik
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Профилактическая медицина и здоровье–
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Graph 3. Indicator of age-related emergency intestinal insufficiency (2015
–
2021)
Based on this material, we conducted a general quantitative analysis of at what age EII
occurs more often (Graph 3)
Graph 4. Disease incidence rate by age
It can be noted that more common cases among people in the period of
35
–
60 mature age. (4 graph).
Emergency intestinal insufficiency treatment plan:
•
Laboratory tests (complete blood count, urinary analysis, blood glucose detection,
micro reaction, determination of bilirubin in biochemistry, determination of AST,
determination of ALT, determination of thymol sample, determination of creatinine amount,
determination of urea amount, determination of proportion of alkaline phosphatase, protein
and protein in blood determination of amylase).
•
Coagulogram (prothrombin index, clotting time, bleeding, fibrinogen, APT).
•
Diagnostic measures (ECG, simple abdominal X-ray, simple chest X-ray, abdominal
ultrasound, abdominal computed tomography)
•
Surgical treatment applied (Graph 5)
Graph 5 Treatments for adhesion and other intestinal dysfunctions
OUTCOME AND DISCUSSION
According to the study, the following data were obtained for patients of the surgery-1
department of the CCH № 7 in the period from 2015 to 2021.
The total number of patients
hospitalized
in
2015-2021
(2015
–
19203
patients,
2016
–
21526
patients,
2017
–
21389 patients, 2017-21923 patients, 2019
–
25042 patients, 200g
–
22462 patients,
2021g
–
29471 patients) As a result, in 2020 we determined the maximum increase in the
intestinal liquidity of the pandemic period and observe an accelerated growth of the total
Profilaktik tibbiyot va salomlatlik
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Профилактическая медицина и здоровье–
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intestinal liquidity. According to the age category, patients aged 35 to 60 years are prone to
this disease.
CONCLUSION
Emergency intestinal insufficiency is not related to age, gender, so all patients with
suspicion should be hospitalized. The result of treatment of emergency intestinal insufficiency
directly depends on the time of the patient's request for medical care, the later the patient is
hospitalized, the higher the mortality rate. Therefore, it is necessary to increase the
effectiveness of diagnosis and tactics for the treatment of emergency intestinal failure.
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