Анализ отдаленных результатов лечения распространенного перитонита у детей

Abstract

Objective. A research objective was the analysis of the remote results of treatment of the widespread purulent peritonitis at children which is carried out by means of the adequate optimized pathogenetic therapy and the active medical examination including prevention of an adhesive disease of an abdominal cavity and correction of dismetabolichesky frustration. Materials and methods. The research is based on the analysis of treatment 339 with widespread peritonitis of various etiology in 17 years (from 2006 to 2017). Children depending on the treatment performed at them were divided into two groups – the main and control. In the main group (237 children) the patients with widespread peritonitis received treatment according to the offered advanced complex strategy. The control group (102 children) was made by children with widespread peritonitis at whom it was carried out traditional complex therapy according to the standard approaches. The research of the remote results of treatment of widespread peritonitis at 142 children is conducted that made 42.88% in the studied groups. At 92 children who had widespread peritonitis the development of symptoms of endothelial dysfunction at an extract is investigated and in the remote period, at 69 patients of both groups the endothelial dysfunction is studied in 3, 6, 12 months, 4 and 7 years. The remote results of a physical condition of the children who had widespread peritonitis with existence or lack of an asthenic syndrome, dispepsichesky frustration, signs of various forms of an adhesive disease are analyzed. The directed treatment of endothelial dysfunction by the medicine Reamberin® and a gepatoprotektor Remaksol®, according to indications – application veno-venous hemodiafiltration was carried out. Children in this group received antiadhesive therapy with use of SMT, fonoforez with collagenases on an anterior abdominal wall and kuprenit inside. Treatment was carried out by courses and after the patient's extract from a hospital. Patients after an extract received bile-expelling medicines (Hofitol within 14 days), eubiotik (Hilak-Forte, Buck-Seth) within 1 month and an endothelial protector (Cytoflavin®). Results. Analyzing the remote results of treatment of children with widespread peritonitis, we revealed higher efficiency of sovershenstvovanny complex treatment of this disease. At the same time it was succeeded to achieve increase in the good remote results of treatment in the main group more than twice in comparison with patients of control group. Conclusions. All above demonstrates more favorable quality of life of the children who received complex treatment of widespread peritonitis according to the strategy developed by us. Key words: widespread peritonitis, endothelial dysfunction, rehabilitation, children, Reamberin, Remaksol, Cytoflavin