rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2022-25-5-344-349uinrlirosped-208Research ArticleСОЦИАЛЬНАЯ ПЕДИАТРИЯSOCIAL PEDIATRICSУспешный опыт применения тедуглутида в лечении детей с синдромом короткой кишкиSuccessful experience in the use of teduglutide in children with short bowel syndromehttps://orcid.org/0000-0003-2917-7451ТропинаЕлена ПавловнаTropinaElena P.

Врач-педиатр, гл. внештатный специалист по паллиативной медицинской помощи детям Департамента здравоохранения Тюменской области, руководитель Центра паллиативной помощи детям ГАУЗ ТО ДЛРЦ «Надежда».

e-mail: tep_1962@mail.ru

Pediatrician, Chief freelance specialist in palliative care for children of the department of health of the tyumen region, head of the Center for palliative care for children, State Healthcare Institution of Regional Healthcare Center «Nadezhda», Tyumen, 625043, Russian Federation.

e-mail: tep_1962@mail.ru

tep_1962@mail.ruhttps://orcid.org/0000-0002-1742-1907ЗмановскаяВера АнатольевнаZmanovskayaVera A.

Канд. мед. наук, гл. врач ГАУЗ ТО ДЛРЦ «Надежда», врач невролог, гл. внештатный специалист по реабилитации детей Департамента здравоохранения Тюменской области.

e-mail: 9798603@mail.ru

9798603@mail.ruЦентр паллиативной помощи детям ГАУЗ ТО «Детский лечебно-реабилитационный центр "Надежда"»Center for Palliative Care for Children «Nadezhda»202214092023255344349Copyright © Тропина Е.П., Змановская В.А., 20232023Тропина Е.П., Змановская В.А.Tropina E.P., Zmanovskaya V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/208

Представлены клинические случаи и обзор методов лечения детей с синдромом короткой кишки (СКК) — редко встречаю­щейся формой патологии, которая требует мультидисциплинарного подхода. Частыми проявлениями СКК являются симптомы мальабсорбции: демпинг-синдром, прогрессирующая потеря массы тела, дефицит макро- и микронутриентов, проявления диспепсии и боли в животе. Число и интенсивность симптомов значительно варьируют среди больных. Тактика лечения таких пациентов включает пожизненное парентеральное питание или, в качестве вынужденной меры, трансплантацию кишечника. Реабилитационные мероприятия у детей с СКК должны включать коррекцию нарушенного всасывания и восстановление нормального трофического статуса; купирование диареи, профилактику и лечение нарушений микробиоты кишечника; уменьшение общих дигестивных изменений. Установлено, что аналог глюкагоноподобного пептида 2 тедуглутид позволяет уменьшить объём парентерального питания, время инфузий и даже добиться полного перехода на энтеральную автономию. Приведены 3 клинических примера, свидетельствующих о том, что лечение СКК у детей тедуглутидом эффективно и безопасно.

Участие авторов

Участие авторов:Тропина Е.П., Змановская В.А. — концепция и дизайн исследования;Тропина Е.П. — сбор и обработка материала;Змановская В.А. — статистическая обработка;Тропина Е.П. — написание текста;Змановская В.А. — редактирование.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. 

Поступила 12

Поступила 12.09.2022Принята к печати 20.09.2022Опубликована 31.10.2022

The article presents an overview of current trends in the approach to the treatment of patients with short bowel syndrome (SBS), including the example of pediatric patients in the Tyumen region. SBC is an extremely rare nosological form in the practice of a clinician and, as a rule, patients with such a diagnosis require a multidisciplinary approach. The most common manifestations of the disease are symptoms of malabsorption: dumping syndrome, progressive weight loss, deficiency of macro- and micronutrients, other manifestations of dyspepsia and abdominal pain. Attention is drawn to the fact that the number and intensity of symptoms varies significantly among patients. The traditional tactic for treating such patients includes the need for lifelong parenteral nutrition or, as a necessary measure, intestinal transplantation. Rehabilitation measures in SBS children should take into account the requirements for correcting impaired absorption and restoring normal trophic status; relief of diarrhea, prevention and treatment of dysbiosis; control and correction of general digestive disorders. We found that the analogue of glucagon-like peptide 2 (GLP-2) — teduglutide — makes it possible to reduce the amount of parenteral nutrition, infusion time, and also achieve a complete transition to enteral autonomy. The method of treatment with Teduglutide is the most promising for patients of this category.

Contribution

Contribution:Tropina E.P., Zmanovskaya V.A. — concept and design of the study;Tropina E.P. — collection and processing of the material;Zmanovskaya V.A. — statistical processing;Tropina E.P. — writing the text;Zmanovskaya V.A. — edi­ting.All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: September 12, 2022Accepted: September 20, 2022Published: October 31, 2022

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