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Изменения объемов водных пространств и секторов организма у больных с абдоминальным сепсисом в процессе жидкостной ресусцитации

Изменения объемов водных пространств и секторов организма у больных с абдоминальным сепсисом в процессе жидкостной ресусцитации

Abstract

У 244 пациентов с признаками абдоминального сепсиса проведено исследование объемов водных пространств и секторов организма двухчастотным импедансным методом. Больные поделены на 12 групп соответственно составу жидкостной ресусцитации и оценкам тяжести состояния по шкале Acute Physiology And Chronic Health Evaluation II (АРАСНЕ ІІ). Выявлено нарастание тяжести проявлений капиллярной утечки вместе с возрастанием тяжести состояния по шкале АРАСНЕ ІІ. При тяжести состояния не больше 10 баллов потери жидкости из сосудов в интерстиций были незначительными. Расстройства водного обмена могли быть успешно устранены исключительно кристаллоидными растворами. При тяжести состояния в пределах 11–20 баллов и более 20 баллов прослеживались очевидные преимущества использования коллоидных плазмозаменителей. Включение в схему лечения всех современных коллоидных плазмозаменителей уменьшало расстройства водного обмена, которые были наиболее тяжелыми при использовании исключительно кристаллоидов. Растворы на основе гидроксиэтилкрахмала имели преимущество перед модифицированной желатиной.

244 patients with the signs of abdominal sepsis were examined for the body fluid volume and body sectors by means of bi-frequency impedance method. 12 groups of patients were formed according to the composition of fluid resuscitation and severity estimation by Acute Physiology And Chronic Health Evaluation-II (АРАСНЕ-ІІ) scale. The progress of severity of capillary lack as well as the severity increase according to the APACHE-II scale were revealed. Under the severity estimation of not more than 10 the fluid lack from vessels into intersticium was insignificant. Fluid exchange failures could be eliminated by crystalloid solutions only. Under the severity estimation within 11–20 and more than 20 the usage of crystalloid plasma substitutes had obvious advantages. Inclusion of all modern colloid plasma substitutes in the treatment scheme decreased the body fluid failures, which were the most severe while using crystalloids only. Solutions on the basis of hydroxyethylstarch had certain advantages over the modified gelatine.

Keywords

АБДОМіНАЛЬНИЙ СЕПСИС, РіДИННА РЕСУСЦИТАЦіЯ, СИНДРОМ КАПіЛЯРНОГО ВИТОКУ, КРИСТАЛОїДИ, ГЕЛОФУЗИН, РЕФОРТАН, ВЕНОФУНДИН, АБДОМИНАЛЬНЫЙ СЕПСИС, ЖИДКОСТНАЯ РЕСУСЦИТАЦИЯ, СИНДРОМ КАПИЛЛЯРНОЙ УТЕЧКИ, КРИСТАЛЛОИДЫ

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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