Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению инфекционного эзофагита

Цель представления клинических рекомендаций, предназначенных для врачей-гастроэнтерологов, врачей общей практики (семейных врачей), врачей-терапевтов, врачей-эндоскопистов, врачей-инфекционистов заключается в изложении современных методов диагностики и лечения инфекционного эзофагита.

Основное содержание. Инфекционный эзофагит представляет собой заболевание пищевода, вызванное грибковыми, вирусными, бактериальными или паразитарными агентами. Пищевод может поражаться изолированно либо как часть распространенной инфекции желудочно-кишечного тракта. Всем пациентам с по дозрением на инфекционный эзофагит, при отсутствии противопоказаний, с целью подтверждения диагноза рекомендуется проведение эзофагогастродуоденоскопии со взятием биопсии. В ряде случаев пациентам с инфекционным эзофагитом с целью верификации инфекционного агента рекомендуется проведение гистологического исследования, иммуногистохимического исследования или анализа методом полимеразной цепной реакции. Пациенты с неосложненным течением инфекционного эзофагита подлежат консервативному лечению. В большинстве случаев оно проводится амбулаторно. Однако при выраженной одинофагии, дисфагии, выраженном болевом синдроме, высоком риске развития осложнений (например, риск развития кровотечения из язв пищевода у пациентов с тромбоцитопенией), тяжелой степени иммунодефицита, развитии генерализованных форм заболевания, тяжелых сопутствующих заболеваниях целесообразна госпитализация пациентов. Клинические рекомендации содержат критерии оценки качества оказания медицинской помощи, информацию для пациента.

Заключение. Диагностика инфекционного эзофагита опирается на клиническую картину (одинофагия, дисфагия), наличие иммуносупрессии, данные эндоскопического и гистологического исследования. Всем пациентам с инфекционным эзофагитом с верифицированным возбудителем рекомендуется проведение соответствующей этиотропной терапии.

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