Influence of complex postoperative therapy on the condition of endogenic intoxication in patients with gastro-pulmonary tolerance independence in the decompensation stage
DOI:
https://doi.org/10.11603/2414-4533.2017.3.8054Keywords:
acute intestinal obstruction, endogenous intoxication, molecules of average mass.Abstract
The aim of the work: to learn the indicators of endogenous intoxication in dynamics in patients with acute articular small bowel obstruction at the stage of decompensation under the influence of complex postoperative therapy.
Materials and Methods. 182 patients with acute articular obstruction of the small intestine were examined. 152 (83.5 %) patients among them were operated and 30 (16.5%) patients were treated conservatively (control group). Patients with decompensated obstruction of the small intestine in the postoperative period were treated with the traditional and proposed by us method, which included lavage, oxygen therapy (Patent of Ukraine for Utility Model No. 81097) and enteral nutrition through an intubation probe. Lavage of the intestine was carried out with a 0.9 % solution of NaCl, enteral nutrition started with the appearance of peristalsis (2nd–3rd day of a postoperative period) with the solution of Peptaman. An additional control group, which consisted of healthy people, was also examined. In order to detect endotoxemia, the levels of the average mass fractions 254 and 280 nm were determined at hospitalization and in the dynamics of treatment in operated and treated conservatively patients.
Results and Discussion. Acute surgical pathology leads to the accumulation of fractions of MSM254 and MSM280 in serum. In the course of treatment, the rates up to 5 days reduce, become lower than during hospitalization, but in all major groups, they continue to exceed the level of the control group and healthy individuals. The method of postoperative treatment of patients with acute articular obstruction of the small intestine in the stage of decompensation was developed by us since 3 days after the operation, accompanied by a significantly lower decrease in the serum content of MSM fractions compared with similar patients treated with the standard method.
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