| الوصف: |
Study objective. The study examined the peculiarities of upper gastrointestinal tract diseases in children suffering from a syndrome of heart connective tissue dysplasia (HCTDS) born from persons exposed to ionizing radiation in a childhood after the ChNPP accident. Materials and methods. The study included 120 children suffering from HCTDS (group I) and 75 persons having no signs of the syndrome (Group II). Diagnosis of HCTDS was obtained from echocardiography in Band M-modes and Doppler echocardiography. Esophagogastroduodenoscopy was performed using a flexible endoscope "OLYMPUS" model GIF-P3. Abdominal diagnostic ultrasound was used to assay the structure of abdominal parenchymal viscera. Results. Upper gastrointestinal tract diseases (UGITD) manifest earlier in children suffering the HCTDS (beginning from a preschool age). Along with age the systemic pattern of organ and system injury becomes evident i.e. there were 6.8 clinical/nosological entities per one child in Group I and 4.9 in Group II. Clinical presentation of chronic UGITD diseases in children suffering concomitant HCTDS were characterized by more frequent exacerbation after the psychoemotional and physical strain, more frequent intestinal motor dysfunction, nervous system disorders (80 %), and chronic infections (62.2 %). Endoscopic pattern of chronic UGITD with concomitant HCTDS featured a combination of mucosal inflammation (a range of various forms of esophagitis, erythematous and hypertrophic gastroduodenopathy) with abnormal gastrointestinal motor function i.e. gastroesophageal and duodenogastric reflux (73.34 %). Destructive lesions at most of duodenal zone were found in 20 %. Conclusions. UGITD namely chronic gastroduodenitis with typically concomitant involvement of several parts of digestive tract are most prevalent within all digestive system diseases in remote period upon the Chornobyl disaster in children born from persons exposed to ionizing radiation in a childhood. Presentation of UGITD occurs earlier in children suffering HCTDS with evident systemic pattern of organ and system injury along with an age. Refluxes of various nature and localization are the leading factors for UGITD onset in children suffering HCTDS. Thus a range of multidirectional tools of reflux disease prophylaxis is required for inclusion to the disease management.Meta. Vyznachyty osoblyvosti hronichnoi' patologii' verhnih viddiliv shlunkovo-kyshkovogo traktu v ditej iz syndromom dysplazii' spoluchnoi' tkanyny sercja (SDSTS), jaki narodylysja vid bat'kiv, oprominenyh v dytjachomu vici v rezul'tati avarii' na ChAES. Materialy i metody. Obstezheno 120 ditej z syndromom dysplazii' spoluchnoi' tkanyny sercja (I grupa) ta 75 pacijentiv bez i'i' oznak (II grupa). SDSTS vstanovljuvavsja za dopomogoju ehokardiografii' u Vi M-rezhymah ta dopplerokardiografii'. Fibroezofago-gastroduodenoskopichne doslidzhennja provodylosja gnuchkym endoskopom GIF-P3 firmy “OLYMPUS”. Struktura parenhimatoznyh organiv cherevnoi' porozhnyny ocinjuvalasja za dopomogoju ul'trasonografichnogo doslidzhennja. Rezul'taty. Vstanovleno, shho u ditej iz SDSTS maje misce bil'sh rannja manifestacija zahvorjuvan' verhnih viddiliv shlunkovo-kyshkovogo traktu(VVShKT) (z doshkil'nogo viku) ta zi zbil'shennjam viku bil'she prostezhujet'sja systemnist' ushkodzhennja riznyh organiv i system (kil'kist' nozologichnyh form hvorob na odnu dytynu u ditej I grupy 6,8, a v II grupi – 4,9). Klinichni projavy hronichnyh zahvorjuvan' VVShKT u ditej iz SDSTS harakteryzujut'sja bil'sh chastymy zagostrennjamy na tli psyhoemocijnyh ta fizychnyh perevantazhen'; bil'shoju chastotoju kyshkovoi' motornoi' dysfunkcii', chastishe suprovodzhujut'sja rozladamy nervovoi' systemy (80,0 %) i hronichnymy vognyshhamy infekcii' (62,2 %). Endoskopichna kartyna hronichnoi' patologii' VVShKT u ditej iz SDSTS harakteryzujet'sja pojednannjam zapal'nogo procesu v slyzovij obolonci u vygljadi riznyh form ezofagitu, erytematoznoi' ta gipertrofichnoi' gastroduodenopatii' z porushennjamy motoryky ShKT u vygljadi gastroezofageal'nogo ta duodenogastral'nogo refljuksiv (73,34 %). Destruktyvni urazhennja, v osnovnomu duodenal'noi' zony, zustrichajut'sja z chastotoju 20,00 %. Vysnovky. V strukturi zahvorjuvan' travnoi' systemy ditej, jaki narodylysja vid bat'kiv, oprominenyh v dytjachomu vici, u viddalenyj period Chornobyl's'koi' katastrofy perevazhaje patologija verhnih viddiliv shlunkovo-kyshkovogo traktu, a same hronichnyj gastroduodenit, shho maje, jak pravylo, spoluchenyj harakter iz zaluchennjam v patologichnyj proces dekil'koh zon travnogo kanalu. U ditej iz SDSTS maje misce bil'sh rannja manifestacija zahvorjuvan' VVShKT ta zi zbil'shennjam viku bil'she prostezhujet'sja systemnist' ushkodzhennja riznyh organiv i system. Providnymy faktoramy u formuvanni patologii' VVShKT u ditej iz SDSTS je refljuksy riznomanitnoi' lokalizacii', shho potrebuje vkljuchennja v terapevtychnyj kompleks riznosprjamovanyh zahodiv z profilaktyky refljuksnoi' hvoroby. |
