PROPHYLAXIS AND TREATMENT OF HYPERENZYMEMIA AND EROSIVE – ULCERATIVE AFFECTIONS OF UPPER PARTS OF GASTRO – INTESTINAL ТRACT IN PATIENTS ON ACUTE PANCREATITIS

Abstract

Treatment of acute pancreatitis is a multidisciplinary problem, in which, along with opera- tive-surgical aspects, components of conservative drug and infusion therapy, aimed at the main pathophys- iological links of the onset and progression of the pathological process, acquire no less importance. The development of acute pancreatitis is characterized by activation of the exocrine function of the pancreas with excessive secretion of enzymes and the occurrence of hyperenzymemia. In addition, among a number of local complications, erosive-ulcerative lesions of the stomach and duodenum are observed, which also require drug correction.Purpose of the work. To substantiate the feasibility and determine the content of antisecretory therapy aimed at suppressing pancreatic function and eliminating organic lesions of the initial parts of the gastro- intestinal tract in patients with acute pancreatitis.Materials and methods. Antisecretory therapy methods were implemented in a selected group of patients in the amount of 73 people aged 28 to 67 years. All patients were divided into two groups. In the main group (46), antisecretory therapy was implemented using drugs – proton pump inhibitors according to the developed original methods. In the comparative group (27), synthetic analogues of somatostatin – octreotide were used. The effectiveness of treatment was assessed by the level of α-amylase in the urine. The nature and severity of organic lesions of the upper parts of the gastrointestinal tract and their dynamics as a result of treatment were detected during esophagogastroduodenoscopy.Results. It was found that proton pump inhibitors contributed to a statistically significant reduction in amylsuria already on the third day from 880,4 ± 20,2 units to 612 ± 18,4 units (p<0.05) with its final normalization on the fifth day – 430 ± 20,4 units (p < 0,05). The appointment of octreotide led to the normalization of the level of α-amylase in the urine only on the fifth day – 910 ± 18,4 units versus 452 ± 16,2 units (p < 0,05). In 32 patients with esophagogastroduodenoscopy-detected erosive-ulcerative lesions of the stomach and duodenum, as a result of therapy with proton pump inhibitors, the elimination of the indicated organic changes occurred.Conclusions. Antisecretory therapy with proton pump inhibitors is an important component of the treatment of acute pancreatitis, which normalizes the level of amylsuria and eliminates erosive-ulcerative lesions of the stomach and duodenum.