Abstract
The aim of the work – to raise treatment efficiency of Kron’s diseases and itscomplications.Material and methods. Analysis of the treatmentof 168 patients with Crohn's diseaseand its complications was carried out. Depending on the treatment algorithm, patientswere divided into two groups: main and comparison group. The main group consistedof 85 (50.5%) patients who were treated according to the developed algorithm, thecomparison group - 83 (49.4%) patients who were treated by traditional methods.Results. The use of a differentiated algorithm for the treatment of Krohn's disease andits complications, which includes inpatients with inflammatory disease, a basic courseof treatment and re-appointment of mesalazine every 6 months, increases the durationof remission. Accordingly, the probability of the recurrence for group I is HR(I / Ia) = 0.25(0.08 - 0.79), which determines the reduction of the recurrence risk in group I 75% (p =0.024). Among patients with complicated form, in particular intestinal stricture, the useof balloon dilatation of the stricture with local administration of prednisolone reducesthe recurrence of stricture. Accordingly, the probability of recurrence for group II isHR = 0.22 (0.08-0.63), which corresponds to 78% reduction in the risk of recurrencein group II. In patients with surgical complications of Crohn'sdisease, intraoperativeadministration of prednisolone into mesentery reduces the recurrence rate and increasethe duration of clinical remission. Accordingly, the probability of recurrence for groupIII is HR (III / IIIa) = 0.23 (0.07 - 0.78), P = 0.036, which determines the reduction ofthe risk of recurrence in group III 77%. This effect of treating Crohn's disease and itscomplications is achieved through the use of a differentiated algorithm.Conclusions. Treatment algorithm of the patients with inflammatory form of Crohn’sdisease, including basic therapy with mesalazines use and obligatory administrationof the prophylactic course of treatment every 6 months, is more efficient in comparisonwith traditional method, that increases recurrence duration and decreases the rate ofrecurrences by 12% against 39.1% (p=0.024) during 12 months.
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