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Синдром системного воспалительного ответа в оперативной гинекологии

Синдром системного воспалительного ответа в оперативной гинекологии

Abstract

Проведено клинико-лабораторное исследование по определению характера и стадии наблюдаемого в послеоперационном периоде синдрома системного воспалительного ответа (ССВО) для разработки простых и безопасных методов его модуляции у гинекологических больных. Изучались проявления ССВО у больных, перенесших стандартные операции на придатках матки традиционным лапаротомическим доступом. В подгруппе I.1 больным проводилось неоптимизированное анестезиологическое пособие и в послеоперационном периоде профилактическая антибактериальная терапия; в подгруппе I.2 − неоптимизированное анестезиологическое пособие и массивная антибактериальная терапия; в подгруппе I.3 − оптимизированное анестезиологическое пособие и профилактическая антибактериальная терапия; в подгруппе I.4 − оптимизированное анестезиологическое пособие и массивная антибактериальная терапия. В группе II производились аналогичные операции на придатках матки, но современным лапароскопическим методом и оказывалось неоптимизированное анестезиологическое пособие. В группе III производились выскабливания полости матки при беременности 4-12 недель и оказывалось неоптимизированное анестезиологическое пособие. Признаки ССВО наблюдались только в I группе. Статистически значимых различий исследуемых показателей в подгруппах I.1 и I.2, а так же в подгруппах I.3 и I.4 не наблюдали. Массивная антибактериальная терапия, проводимая в подгруппах I.2 и I.4, на показатели ССВО не влияла. Оптимизированное анестезиологическое пособие, проводимое в подгруппах I.3 и I.4, снижало проявления ССВО. Оперативное вмешательство при неоптимизированном анестезиологическом пособии в группах II и III признаков ССВО не вызывало. Наблюдаемые признаки ССВО относились к его второй стадии и являлись ответной реакцией организма больного на хирургический стресс.

The clinic and laboratory examination on definition of character and stage of the systemic inflammatory response (SIR) in a postoperative period for development of prime and safe methods of its modulation at gynaecology patients is carried out. The SIR`s displays was studied at the patients who had traditional laparotomic operations. The patients in a subgroup I.1 carried out not optimized anesthetic manual and preventive antibacterial therapy in a postoperative period; in a subgroup I.2 not optimized anesthetic manual and massive antibacterial therapy; in a subgroup I.3 optimized anesthetic manual and preventive antibacterial therapy; in a subgroup I.4 optimized anesthetic manual and massive antibacterial therapy. For patients in a group II the similar operations on appendages of a uterus were yielded, but it appeared by a modern laparoscopic method and not optimized anesthetic manual. In group III the currettages of the cavity uterus were yielded at pregnancy 4-12 weeks and it appeared not optimized anesthetic manual. The attributes of SIR were observed only in to group I. Statistically significant differences of explored indexes in subgroups I.1 and I.2, and as in subgroups I.3 and I.4 did not observe. The massive antibacterial therapy spent for subgroups I.2 and I.4 on indexes SIR did not influence. Optimized anesthetic manual, spent for subgroups I.3 and I.4, reduced of SIR displays. In groups II and III the operative measure at not optimized anesthetic manual was not accompanied by occurrence of SIR attributes. The apparent of SIR attributes fell into of its second stage and were answer-back response of an organism of the patient to a surgical stress.

Keywords

СИНДРОМ СИСТЕМНОГО ВОСПАЛИТЕЛЬНОГО ОТВЕТА,ОПЕРАТИВНАЯ ГИНЕКОЛОГИЯ

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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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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