ОСТРОЕ ПОВРЕЖДЕНИЕ ПОЧЕК ПРИ ТЯЖЕЛОМ ОСТРОМ ПАНКРЕАТИТЕ (ОБЗОР ЛИТЕРАТУРЫ)

Abstract

Acute pancreatitis is characterized as a complex of morphofunctional changes in the stroma of the pancreas, and in parapancreatic fatty tissue, surround- ing organs and tissues, as well as manifestations of the syndrome of multiple organ dysfunction due to the activity of metabolites and enzyme toxemia, which in turn determines the clinical picture of the disease, as well as the risks of complications and high mortality rates. In xx century, the main peak of mortality were patients in the early phase of the disease, while at present to 80% of deaths related to the phase of the development of septic complications and multiple organ failure. In many respects, this trend is explained by the lack of unity of views on the etiopathogenesis of the disease, the difficulties of early diagnosis and the high frequency of diag- nostic errors, which entails a delay in the provision of specialized care to the patient. Another reason is seen in the development of multi-organ dysfunction, which aggravates the patient’s condition and, closing the vicious circle, leading to serious complications and fatal outcomes. One of the leading component of multiple organ dysfunction developing decompensated acute surgical pathology of the abdominal cavity and retroperitoneal space, should be considered as acute renal failure, as- sociated with high mortality isolated (78%), while engaging in decompensation three or more organ systems tends to the absolute. At the same time, the frequency of acute kidney damage becomes the leading problem in the treatment of such patients in recent years. Even in the case of a favorable outcome in the development of isolated or combined renal dysfunction in patients with pancreatic necrosis is a significant weighting of the rehabilitation period, prolonged phase of inpatient treatment and regularly raises its cost. At present, there has been a steady increase in the number of patients with severe forms of acute pancreatitis with acute kidney damage, especially in the working-age group. Not always satisfactory results of their treatment are the reason for further in-depth studies in this direction.