surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2020-10-2-122-129surgonco-489Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSНеоперативные методы лечения дивертикулита ободочной кишки (обзор литературы)Non-Surgical Treatment of Colonic Diverticulitis (a Review)https://orcid.org/0000-0002-4832-6363ТимербулатовШ. В.TimerbulatovSh. V.

Тимербулатов Шамиль Вилевич — д.м.н., кафедра хирургии с курсом эндоскопии ИДПО.

тел.:+7(927)3073333

Shamil V. Timerbulatov — Dr. Sci. (Med.), Department of Surgery with a course of Endoscopy for Advanced Professional Education.

tel.: +7(927)3073333

timersh@yandex.ruhttps://orcid.org/0000-0002-2320-9558ГайнуллинаЭ. Н.GainullinaE. N.

Гайнуллина Эльза Нажиповна — кафедра хирургии с курсом эндоскопии ИДПО.

тел.: +7(917)4326976

Elza N. Gainullina — Department of Surgery with a course of Endoscopy for Advanced Professional Education.

tel.: +7(917)4326976

ehl2368@yandex.ruhttps://orcid.org/0000-0002-6664-1308ТимербулатовМ. В.TimerbulatovM. V.

Тимербулатов Махмуд Вилевич — д.м.н., профессор, кафедра факультетской хирургии с курсом колопроктологии.

тел.: +7(917)3577528

Mahmud V. Timerbulatov — Dr. Sci. (Med.), Prof., Department of Departmental Surgery with a course of Coloproctology.

tel.: +7(917)3577528

timerm@yandex.ruБашкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian Federation202025072020102122129Copyright © Тимербулатов Ш.В., Гайнуллина Э.Н., Тимербулатов М.В., 20202020Тимербулатов Ш.В., Гайнуллина Э.Н., Тимербулатов М.В.Timerbulatov S.V., Gainullina E.N., Timerbulatov M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/489

Дивертикулярная болезнь ободочной кишки по распространенности, многообразию клинических проявлений, наличию осложнений представляет не только медицинскую, но и огромную социальную проблему. С увеличением продолжительности жизни населения до 80 лет и более она приобретает угрожающий характер. Многие принципы, использовавшиеся ранее, потеряли свою актуальность на настоящий момент. Это диктует необходимость ранней диагностики дивертикулярной болезни ободочной кишки, адекватной терапии и профилактики данной патологии. В данной статье представлен обзор литературы по консервативным методам лечения воспалительных осложнений — дивертикулита ободочной кишки. За последние 20 лет отмечен заметный рост числа госпитализаций пациентов с осложненным дивертикулитом (до 20 %), что также увеличивает финансовые расходы на лечение. Рассмотрены вопросы диагностики, критерии оценки тяжести дивертикулита на основании лабораторных, биохимических исследований, лучевых методов визуализации (компьютерная томография, магнитно-резонансная томография, ультразвуковое исследование, колоноскопия). Проведен критический анализ возможностей противовоспалительных, антибактериальных препаратов в профилактике рецидивов и лечении острого и рецидивного дивертикулита, показания к амбулаторному ведению. Несмотря на множество проведенных клинических исследований и опубликованных рекомендаций, вопросы выбора лекарственных препаратов, их дозировок и длительности приема остаются открытыми.

Colonic diverticulitis poses an adverse medical and social problem for its prevalence, variety of clinical manifestations and complications and is becoming menacing as the people’s life expectancy reaches beyond 80 years. Many of the traditional principles no longer apply. This situation warrants an earlier diagnosis of colonic diverticulitis, its adequate treatment and prevention. The article presents a review of current literature on the conservative treatment of inflammatory colonic diverticulitis. The past 20 years have witnessed a noticeable increase to 20 % of hospitalisation rate with complicated diverticulitis and a higher associated financial burden. We discuss issues in the diagnosis and criteria for diverticulitis severity assessment with laboratory, biochemical data and radiation imaging (computer tomography, magnetic resonance imaging, ultrasound, colonoscopy). A critical overview is provided on anti-inflammatory and antibiotic drug usage in recurrence prevention and treatment of acute and recurrent diverticulitis, aside to recommendations in outpatient care. Despite a manifold of clinical studies and guidelines available, the adequate choice of drugs, dosages and duration of treatment remains an open challenge.

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The authors declare that there are no conflicts of interest present.