Abstract
Objectives - to improve the treatment results in patients with generalized peritonitis complicated by the enteral insufficiency syndrome. Material and methods. In the period of 2016 -2018 there were 45 patients with a widespread peritonitis admitted to Samara regional clinical hospital named after V.D. Seredavin for treatment. The patients were divided into a control and a main group. The patients of the main group received the intestinal intubation with a specially designed catheter, the intestinal lavage during surgery and in the early postoperative period, the enterosorption, enteral nutrition and bowel decontamination; and in the absence of contraindications - the enteral oxygen therapy. Dynamics of the enteral insufficiency syndrome (EIS) development in both groups were evaluated according to the defined criteria, including laboratory and clinical indicators. Each criterion could weight from 1 to 3 points, their amount reflected the degree of enteral insufficiency. Results. In the main group of patients the small intestinal function was notably restored till the beginning of the third day, what coincided with the transition of the third degree of enteral insufficiency in the second. In patients of the control group the restoration of intestinal function was starting in period of fifth and sixth day after the operation, but the 3d degree of enteral insufficiency remained for 12 hours. Conclusion. The intestinal treatment in combination with the standard therapy allowed to reduce the degree of EIS in the beginning of treatment. This helped to improve the treatment results in general.
Highlights
Objectives – to improve the treatment results in patients with generalized peritonitis complicated by the enteral insufficiency syndrome
Dynamics of the enteral insufficiency syndrome (EIS) development in both groups were evaluated according to the defined criteria, including laboratory and clinical indicators
In the main group of patients the small intestinal function was notably restored till the beginning of the third day, what coincided with the transition of the third degree of enteral insufficiency
Summary
Цель – улучшение результатов лечения пациентов с распространенным перитонитом, осложненным синдромом энтеральной недостаточности. Середавина проходили лечение 45 пациентов с распространенным перитонитом. Пациенты были разделены на две группы – контрольную и основную. Пациентам основной группы выполняли интестинальную интубацию разработанным зондом оригинальной конструкции, во время операции и раннем послеоперационном периоде проводили внутрикишечный лаваж, энтеросорбцию, энтеральное питание и селективную деконтаминацию кишечника, а при отсутствии противопоказаний – энтеральную оксигенотерапию. Динамику развития СЭН в исследуемых группах оценивали согласно разработанным критериям, включающим лабораторные и клинические показатели. Каждому критерию присваивалось от 1 до 3 баллов, их сумма отражала степень энтеральной недостаточности. У пациентов основной группы восстановление функций тонкой кишки отмечали к началу третьих суток; это совпадало с переходом третьей степени энтеральной недостаточности во вторую. У пациентов контрольной группы перистальтические шумы в среднем появлялись к www.innoscience.ru. Objectives – to improve the treatment results in patients with generalized peritonitis complicated by the enteral insufficiency syndrome
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