| Abstract | NASLOV: Probir bolesnika s upalnom bolešću crijeva za liječenje biološkom terapijom.
CILJ ISTRAŽIVANJA: Analizirati učestalost komplikacija kod bolesnika s upalnom bolesti crijeva koje zahtijevaju hospitalizaciju. Odrediti uobičajeno i najčešće korišteno liječenje bolesnika koji se hospitaliziraju, te odrediti preporuke kod otpusta.
MATERIJAL I METODE: Izvršeno je retrospektivno istraživanje u kojem je obrađeno 60 bolesnika koji su pod dijagnozom upalne bolesti crijeva primljeni na Kliniku za unutarnje bolesti, KBC Split u razdoblju od 2012. godine do 2015. godine. Obrađeni su podaci iz povijesti bolesti o dobi, spolu, vremenu proteklom od dijagnoze, laboratorijskim nalazima, te liječenju. Korišten je program Microsoft Excel za obradu podataka.
REZULTATI: Od 60 obrađenih bolesnika 32 (53%) je bolovalo od Crohnove bolesti, 24 (40%) od ulceroznog kolitisa, a 4 (7%) su imala nedeterminirani kolitis. Najmlađi bolesnik imao je 18 godina, najstariji 72 godine. Srednja dob je bila 36 godina. 34 bolesnika su bila muškog spola (57%), dok su 26 bili ženskog spola (43%). Upalna bolest crijeva je kod 8 bolesnika bila novootkrivena (13%), dok je kod 52 bolesnika (87%) poznata već od prije. Najduži tijek bolesti bio je 372 mjeseca, dok je najkraći bio 1 mjesec. Razlog hospitalizacije najčešće su bile učestale proljevaste stolice (40 bolesnika – 67%). Zatim krv u stolici (28 bolesnika – 47%), bol u trbuhu (22 bolesnika – 37%), febrilitet (18 bolesnika – 30%), opća slabost (9 bolesnika – 15%) i najrjeđe uporno povraćanje (4 bolesnika – 7%). 17 bolesnika (28%) bilo je slabije, 41 bolesnik (68%) srednje, a samo 2 bolesnika (4%) bila su jače koštano-mišićne građe. 33 bolesnika (55%) bila su hospitalizirana kraće od 10 dana, 16 (27%) između 10 i 20 dana, a 11 (18%) duže od 20 dana. Najčešće korištene skupine lijekova bili su aminosalicilati i kortikosteroidi. Uporaba antibiotika povećala se za vrijeme hospitalizacije i po otpustu. Korištenje biološke terapije se smanjilo za vrijeme hospitalizacije.
ZAKLJUČAK: Komplikacije upalne bolesti crijeva su učestale, osobito kod Crohnove bolesti koja je sklonija komplikacijama jer je klinički i patohistološki teža bolest od ulceroznog kolitisa. Duljina trajanja bolesti nije ključni faktor kod razvoja komplikacija. Prije hospitalizacije najčešće korišteni lijekovi bili su aminosalicilati. Kortikosteroid, imunomodulatori i biološka terapija rjeđe, a antibiotici najrjeđe. Za vrijeme hospitalizacije porasla je uporaba antibiotika, a smanjena uporaba biološke terapije jer je uporaba antibiotika kontraindikacija za uporabu biološke terapije. Po otpustu često se antibiotska terapija nastavljala kratko vrijeme, a nakon toga nastavak terapije kakva je bila prije hospitalizacije. Kod određenog broja bolesnika iskazana je potreba je za uvođenjem biološke terapije. |
| Abstract (english) | RESEARCH OBJECTIVE: To analyze the frequency of complications in patients with inflammatory bowel disease that require hospitalization. To identify common and most commonly used treatment for patients who are hospitalized, and to determine the recommendations at release.
MATERIAL AND METHODS: Retrospective study has been done which included 60 patients who were diagnosed with inflammatory bowel disease, admitted to the Clinic for Internal Medicine, University Hospital Split in the period from year 2012 to year 2015. Data from their files (gender, age, time since diagnosis, laboratory results and treatment) were analysed. Microsoft Excel was used for data analysis.
RESULTS: Of the 60 patients included 32 (53%) suffered from Crohn's disease, 24 (40%) from ulcerative colitis and 4 (7%) had indeterminate colitis. The youngest patient was 18, the oldest 72 years old. The median age was 36 years. 34 patients were male (57%), while 26 were female (43%). Inflammatory bowel disease was newly discovered at 8 patients (13%), while 52 patients (87%) were already diagnosed before. The longest course of disease was 372 months, while the shortest was 1 month. The most frequent reason for hospitalization were watery stools (40 patients - 67%). Other reasons were blood in the stool (28 patients - 47%), abdominal pain (22 patients - 37%), fever (18 patients - 30%), weakness (9 patients - 15%) and least often persistent vomiting (4 patients - 7 %). 17 patients (28%) had low, 41 patients (68%) medium, and only 2 patients (4%) high nutritional status. 33 patients (55%) were hospitalized for less than 10 days, 16 (27%) between 10 and 20 days, and 11 (18%) more than 20 days. The most commonly used drugs were aminosalicylates and corticosteroids. Use of antibiotics has increased during hospitalization and after release. Use of biological therapy was reduced at the time of hospitalization.
CONCLUSION: The complications of inflammatory bowel disease are frequent, especially in Crohn's disease, which is more prone to complications as it is clinically and histologically more severe disease than ulcerative colitis. The duration of illness was not a key factor in the development of complications. Before hospitalization most commonly used drugs were aminosalicylates. Corticosteroids, immunomodulators and biologic therapy were used less often, and antibiotics are the rarest. During hospitalization use of antibiotics had incesed and the use of biological therapy had decresed becouse the use of antibiotics is an contraindication for the use of biological therapie. After discharge, antibiotic therapy often continued for a short period of time. Antibiotic therapy was then followed by the same therapy as before hospitalization. Some patients also needed the introduction of biological therapy. |
