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The aim of this study is to develop a scale of risk factors scoring and mathematical model of individual choice of the method of surgical treatment of duodenal ulcer.
Materials and methods. The prognostic value of individual clinical manifestations of duodenal ulcer and intraoperative anatomical changes in 99 patients with duodenal ulcer was studied. The study was carried out with the help of the developed questionnaire of initial clinical information and data of intraoperative anatomical situation in patients with duodenal ulcer. For mathematical processing of clinical signs the latter were marked with numbers. Based on the prognostic value of each factor, the second stage of this study was the construction of decisive rules to determine the individual choice of the type of surgery. The problem was solved separately for each type of operation: gastric resection, stem vagotomy with gastroduodenoanastomosis according to Jaboulet, selective proximal vagotomy.
Results of the study and their discussion. On the basis of the analysis of information value of clinical signs, in the groups of patients who underwent selective proximal vagotomy, stem vagotomy with gastroduodenoanastomosis according to Jaboulet and gastric resection the prognostically unfavourable (risk factors of unfavourable distant result of surgical intervention) were revealed. Based on the prognostic value of each factor, the second stage of this study was the construction of decisive rules to determine the individual choice of the type of surgery.
Conclusion. The applied decisive rules, the stated principles of mathematical substantiation of possible risk factors of unsatisfactory results of various operative interventions in duodenal ulcer disease, as well as the previously developed differentiated clinical indications, allowed us to avoid duodenal stump failure (within three years) and to reduce the postoperative lethality from 4, 5% to 1,5%.
Keywords:prognosis, mathematical modelling, scoring scale, risk factors of unsatisfactory results, decisive rules, choice of the method of surgical treatment of duodenal ulcer disease, gastric resection, stem vagotomy with gastroduodenoanastomosis according to Jaboulet, selective proximal vagotomy.
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