The Relationship of Disorders in the Hemostasis System with Changes in Homeostasis in Conditions of Progressive Inflammation

Abstract

The urgency of the problem of acute peritonitis in surgical practice is due to the annual increase in morbidity, a high number of complications, therapeutic complexity and mortality. Materials and methods. The material of the study was 45 patients with acute peritonitis, who were divided into 3 groups depending on the course of pathology after surgery. The first group (n=15) – without complications, the second (n=15) – with wound complications, the third (n=15) – with tertiary peritonitis and sepsis. In addition to standard research methods, a number of laboratory tests are included to determine the severity of intoxication, oxidative activity, the state of the blood coagulation system, and the functional state of the liver. The study period is the 1st, 5th, 10th postoperative day. Results. The results showed that in the early period after surgery in patients with acute peritonitis, the state of hypercoagulemia, inhibition of fibrinolysis correlate with lipid peroxidation, endogenous intoxication, and violation of the functional status of the liver. With effective therapy, during the early postoperative period, the state of the hemostasis system and homeostasis indicators are corrected against the background of restoration of the functional status of the liver. With the aggravation of the phenomena of inflammation in the early postoperative period and the development of complications, there is a progression of changes in the studied indicators of homeostasis and hemostasis with further inhibition of the functional state of the liver. With the development of tertiary peritonitis and sepsis, the hemostasis system is modified in the form of hypocoagulemia and activation of fibrinolysis against the background of a sharp increase in endogenous intoxication, lipid peroxidation and greater inhibition of the functional status of the liver, including from its hemostasis-regulating component. Conclusions. The obtained results indicate the presence of a reliable correlation of disorders in the hemostasis system with changes in homeostasis in conditions of progressive inflammation.