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Differentiated approach to antihypoxic and endoportal therapy in treatment of discharged peritonitis complicated by syndrome of intestinal insufficiency

[Surgery]
Mikhail Topchiev; Dmitriy Parshin; Eldar Kchibekov; Petr Birukov; Misrikhan Misrikhanov;

Objective of this research was improvement of the results of treatment of patients with diffuse peritonitis by the differentiated use of enteral anti-hypoxemic and endoportal therapy. The results of surgery in 183 patients with diffuse peritonitis were analyzed. Enteral anti-hypoxemic therapy was performed by introduction of oxygenic water through the nazogastrointestinal probe. Endoportal therapy was performed after catheterization of the right gastroomental vein by introduction of antibiotic, hepatoprotective and anti-hypoxemic drugs. The blood gas composition, acid-base state, integrated indicators of the clinical severity and inflammatory changes of abdominal organs were investigated. The enteral anti-hypoxemic and endoportal therapy effectively prevented the enteral insufficiency development and improved the results of treatment.

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References:
1. Levit A. L., Malkova O. G., Galimzyanov F. V., Krasheninnikov S. V. Intensive care in patients with severe abdominal sepsis and multiple organ failure. Uralsky meditsinsky zhurnal. – Ural medical journal. 2007;10:29-32. (In Russ.).
2. Savelyev V. S. Peritonit I endotoksinovaya agressiya. M.: «Meditsina», 2012. (In Russ.).
3. Yermolov K. K., Bagdatyev V. E. Assessment of the Mannheim peritoneal index. Vestn. khirurgii im I. I. Grekova. – Westn. surgery named after I. I. Grekov. 1996;3:22. (In Russ.).
4. Takha Kh. D., Allniazi A. Ye., khmanov A. K., Inyutin A. S. Features of the course of enteral insufficiency syndrome in patients with advanced peritonitis. Kazansky meditsinsky zhurnal. – Kazan medical journal. 2015;96(4):489-492. (In Russ.).
5. Konden R., Naykhauz L. Klinicheskaya khirurgiya. M.: «Praktika», 1998. (In Russ.).
6. Topchiyev M. A., Kchibekov E. A., Parshin D. S., Orlov F. V. Sposob diagnostiki posleoperatsionnogo peritonita. Patent RUS 2456621 ot 31.03.2011 (In Russ.).
7. Chernov V. N., Belik B. M., Pshukov Kh. Sh. Prediction of outcome and choice of surgical tactics in common purulent peritonitis. Khirurgiya. – Surgery. 2004;3:47-50. (In Russ.).
8. Barie Ph. S., Hydo L. J., Ficher E. Development of Multiple Organ Dysfunction Syndrome in Critically ill Patients with Perforated Viscus. Arch. Chir. 1996;131:37-43.
9. Bosscha K., Reijnders K., Hulstaert P. F. Prognostic scoring systems to predict outcome in peritonitis and intra-abdominal sepsis. Br. J. Surg. 1997;84(11):1532-1534.
10. Shibitov V. A., Vlasova T. I., Polozova E. I., Vlasov P. A. Pathogenetic bases of enteric insufficiency. Fundamentalnye issledovaniya. – Fundamental study. 2012;4:152-156. (In Russ.).
11. Savelyev V. S. Criteria for the selection of effective tactics of surgical treatment of common peritonitis. Annaly khirurgii. – Annals of surgery. 2013;2:48-54. (In Russ.).
12. Sukovatykh B. S., Blinkov Yu. Yu., Frolova O. G. Mechanisms of development of common peritonitis. Vestnik eksperimentalnoy I klinicheskoy khirurgii. – Bulletin of experimental and clinical surgery. 2012;2:469-477. (In Russ.).
13. Fedoseyev A. V. On the diagnosis of early signs of multi-organ dysfunction in patients with enteric insufficiency syndrome. Vestnik eksperimentalnoy I klinicheskoy khirurgii. – Bulletin of experimental and clinical surgery. 2012;5(1):60-64. (In Russ.).
14. Demmel N., Maag K., Osterholzer G. The value of clinical parameters for determining the prognosis of peritonitis – validation of the Mannheim Peritonitis Index. Langenbecks Arch. Chir. 1994;379(3):152-158.
15. Solovyev I. A., Kolunov A. V. Postoperative intestinal paresis is a problem of abdominal surgery. Vestnik Natsionalnogo mediko-khirurgicheskogo tsentra im. N. I. Pirogova. – Bulletin of the National medical and surgical Center. N. I. Pirogov. 2013;8(2):112-118. (In Russ.).
16. Van Goor H. Interventional management of abdominal sepsis: when and how. Springer-Verlag GmbH. 2002;387(5-6):191-200.
17. Parshin D. S., Topchiyev M. A. Treatment of intestinal insufficiency syndrome in patients with spilled peritonitis. Vestnik Tambovskogo universiteta. Seriya: Yestestvennye i tekhnicheskiye nauki. – Bulletin of Tambov University. Series: Natural and technical Sciences. 2013;18(1):296-298. (In Russ).
18. Abu Varda F. Kh. Enteralny put korrektsii sindroma kishechnoy nedostatochnosti v khirurgicheskoy taktike lecheniya bolnykh s urgentnoy abdominalnoy patologiyey. Ryazan, 2012. (In Russ.).
19. Wittmann D. H., Teichmann W., Muller M. Development and validation of the Peritonitis-Index-Altona (PIA II). Langenbecks Arch.Chir. 1987;372:834-835.

Keywords: diffuse peritonitis, index of an abdominal cavity, anti-hypoxemic therapy, endoportal therapy, syndrome of an enteral failure, nazogastrointestinal intubation, integrated scales


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