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Несостоятельность кишечных швов при вторичном перитоните — основная причина третичного перитонита

Несостоятельность кишечных швов при вторичном перитоните — основная причина третичного перитонита

Abstract

It is established in the article on the basis of retrospective analysis of 56 cases of pathanatomical researches that tertiary peritonitis in 93% of cases was caused by an incompetence of intestinal sutures and intestine perforation against secondary purulent peritonitis. About 340 ml of purulence (from 80 to 1500 ml) is found at autopsy in 37 cases in an abdominal cavity. The passive drainage of abdominal cavity with tubes was noneffective in 35%. In the second group Fibrin applying on intestinal loops on the average in 29,8 days after the last operation was made in 19 observations. Relaparotomies were carried out on demand from 1 to 6 times (on the average 2,6 times) that at the erased clinic of flaccid peritonitises raises doubts in correctness of a choice. Dominating infection were Proteus vulgaris and mirabilis — 44%, Staphil. Aureus — 38%.

В статье на основе ретроспективного анализа 56-ти случаев патанатомических исследований установлено, что третичный перитонит в 93 % случаев наступил в результате несостоятельности кишечных швов и перфорации кишечника на фоне вторичного гнойного перитонита. При аутопсии в 37-ми случаях в брюшной полости обнаружено в среднем 340 мл гноя (от 80 до 1500 мл). Пассивное дренирование брюшной полости трубками в 35 % оказалось неэффективным. Во второй группе в 19-ти наблюдениях было произведено наложение фибрина на петлях кишечника в среднем через 29,8 дней после последней операции. Релапаротомии выполнялись по требованию от 1-го до 6-ти раз (в среднем 2,6 раза), что при стертой клинике вялотекущих перитонитов вызывает сомнение в правильности выбора. Доминирующей инфекцией явились Proteus vulgaris и mirabilis — 44 %, Staphil. Aureus — 38 %.

Keywords

НЕСОСТОЯТЕЛЬНОСТЬ КИШЕЧНЫХ ШВОВ, ТРЕТИЧНЫЙ ПЕРИТОНИТ, НОЗОКОМИАЛЬНАЯ ИНФЕКЦИЯ, РЕЛАПАРОТОМИЯ «ПО ТРЕБОВАНИЮ», ПАССИВНОЕ ДРЕНИРОВАНИЕ ТРУБКАМИ, RELAPAROTOMY «ON DEMAND»

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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
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