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Некоторые аспекты лечения больных с острой кишечной непроходимостью

Некоторые аспекты лечения больных с острой кишечной непроходимостью

Abstract

Цель исследования улучшение результатов лечения больных с острой кишечной непроходимостью путем разработки и внедрения рациональной программы профилактики и лечения послеоперационных осложнений. Материал и методы. За 4 года в отделение хирургии ГдВВ (Госпиталь для ветеранов войн) г. Казани было госпитализировано 106 больных с различными формами острой непроходимости тонкого кишечника (ОКН). Диагноз устанавливали на основании анамнеза, осмотра, характерных рентгенологических признаков, ультразвукового исследования, рентгеноконтрастной диагностики. Все госпитализированные больные получали стандартное лечение, направленное, прежде всего, на борьбу с шоком и интоксикацией, коррекцию водно-электролитного и белкового баланса, восстановление естественного пассажа по кишечнику. Результаты и их обсуждение. В результате лечения у 83 (78,3%) пациентов явления кишечной непроходимости разрешились консервативным путем, в 23 (21,7%) случаях ввиду неэффективности консервативных методов пациенты были прооперированы. Определены подходы инфузионной терапии на различных стадиях кишечной непроходимости. В послеоперационном периоде частота гнойно-септических осложнений составила 17,3% (4 случая). В послеоперационном периоде умер 1 больной. Общая послеоперационная летальность составила 4,3%. Заключение. На программу комплексного метода лечения больных с острой непроходимостью тонкого кишечника, безусловно, оказывает влияние и такие факторы, как возраст больного, сроки госпитализации, патологический процесс в брюшной полости, наличие и характер сопутствующей патологии.

The purpose of the research is to improve the results of treatment of patients with acute intestinal obstruction, by developing and implementing a rational program of prevention and treatment of postoperative complications. Material and methods. For 4 years in surgery department at HfVW in Kazan 106 patients with various forms of acute intestine obstruction were hospitalized (IPOs). Diagnosis was based on anamnesis and examination, the radiographic signs, ultrasound, diagnostic radiopaque. All hospitalized patients received standard treatment aimed primarily to combating shock and intoxication, correction of water-electrolyte and protein balance, restore natural passage through the intestines. Results and discussion. As a result of treatment ileus resolved conservatively in 83 (78,3%) patients, in 23 (21,7%) cases due to the ineffectiveness of conservative methods, patients were operated on. The approaches of infusion therapy at various stages of intestinal obstruction are determined. Postoperatively, the frequency of purulent-septic complications was 17,3% (4 cases). Postoperatively, 1 patient died. Overall postoperative mortality was 4,3%. Conclusion. The complex treatment of patients with acute intestinal ileus certainly influenced by such factors as the patient''s age, length of stay, the pathological process in the abdominal cavity, the presence and nature of comorbidity.

Keywords

ИНФУЗИОННАЯ ТЕРАПИЯ, ГНОЙНО-СЕПТИЧЕСКИЕ ОСЛОЖНЕНИЯ, ОСТРАЯ ТОНКОКИШЕЧНАЯ НЕПРОХОДИМОСТЬ, ПЕРИОПЕРАЦИОННАЯ АНТИБИОТИКОПРОФИЛАКТИКА

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold