Качество диспансерного наблюдения детей с атопическим дерматитом с периода манифестации заболевания до возраста 13–17 лет

Abstract

The purpose — to analyze the quality of dispensary observation of children with atopic dermatitis from the period of the disease manifestation to the age of 13–17 years. Material and methods. 350 children aged 13–17 with atopic dermatitis were examined (observation group). Information for studying the disease history was obtained from the analysis of medical documentation (form No. 025/y-04 «Medical record of an outpatient patient» and form 003/y «Medical record of an in-hospital patient»), as well as by interviewing and questioning patients and their parents. The comparison group consisted of 350 children aged 13–17, health groups I and II, without allergic diseases. Results. Atopic dermatitis in most children manifested in the first year of life. The leading reasons for early manifestation were the transfer to artificial feeding, the introduction of complementary foods. A retrospective analysis of the dispensary observation of children with atopic dermatitis showed that more than half of the children were regularly observed for the disease, followed the recommended diet, and received basic therapy in the first 2 years from the diagnosis. Subsequently, indicators of observation by doctors according to the pathology profile, adherence to a hypoallergenic diet, and compliance with treatment recommendations decreased and were carried out only during the period of AD exacerbation. In children with a mild course of the disease, the rates of compliance with recommendations for therapeutic nutrition, treatment in the first 2 years from the disease manifestation were higher compared to patients with moderate and severe course. The level of sanatorium-and-spa treatment during the period of dispensary observation was low. Conclusion. The conducted analysis testifies that regular observation by doctors according to the disease profile, implementation of recommendations on a hypoallergenic diet, basic therapy in children with atopic dermatitis influence the level of severity of the disease by the age of 13–17 years old. In order to increase the effectiveness of dispensary observation, it is advisable to conduct classes for parents on the disease, the role of following the recommendations for observation by doctors, diet and treatment in preventing the formation of severe forms of the disease.