[Choice of surgical management and methods of detoxication in patients with acute intestinal obstruction].
A comparative analysis of the results of treatment in 892 patients with various forms of acute bowel obstruction (ABO) of non-tumor genesis has been performed. High informative values of the intraoperative biomicroscopy of bowel wall for evaluation of severity of ischemic damage and viability of the intestine in ABO. The endotoxicosis (ET) in patients with ABO is proposed to be assessed on the basis of integral assessment of clinical and laboratory values of hemostasis. Basic principles of the choice of surgical policy and methods of detoxication in ABO with regard for the grade of ischemic damage of the bowel wall and the ET level are described. The application of the developed methods in patients with ABO allows to avoid mistakes in evaluation of bowel viability, to reduce the rate of development of toxicoseptic shock from 9.8% to 4.7% and to decrease postoperative lethality rate from 12.7% to 6.5%.
Chernov
V N
VN
Belik
B M
BM
D000208:Acute Disease; D000368:Aged; D003657:Decision Making; D019446:Endotoxemia / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007422:Intestines / Q000098:blood supply; D007511:Ischemia / Q000150:complications / Q000175:diagnosis; D016343:Monitoring, Intraoperative; D010956:Plasmapheresis; D012772:Shock, Septic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013514:Surgical Procedures, Operative / Q000379:methods*; D015996:Survival Rate