Optimization of the diagnostic and treatment program at the stages of surgical treatment of patients with acute obstruction of the small intestine
DOI:
https://doi.org/10.24144/2415-8127.2018.57.48-53Keywords:
small intestine, obstruction, diagnostics, treatment.Abstract
Recently, despite the current advances in the diagnosis and treatment of acute obstruction of the small intestine (AOSI), no significant progress has been made in solving the problem of this disease and the mortality rate remains rather high. The purpose of the study is to optimize the diagnostic and treatment program for patients with AOSI at different stages of providing them help to improve the results of their surgical treatment. Materials and methods. 307 patients with AOSI conducted a comprehensive examination: clinical, X-ray, sonographic research, computer tomography. In 221 (79,78%) patients, surgical treatment of the disease was performed, in 56 (20,22%) cases conservative treatment was performed. In 30 cases a retrospective analysis of causes of lethality was conducted. Survey Results and Discussions. On the basis of the conducted surveys, patients were diagnosed AOSI. In addition, each patient has a functional state for the operation– compensated or decompensated. This became the basis for determining the treatment tactic– operational or conservative. In 56 patients, SSTC was able to dissolve therapeutically. In 221 patients, various types of surgical interventions were performed to eliminate AOSI. Patients in the first and second stages of the AOSI with a compensated functional state, depending on the intraoperative situation, can perform all types of surgical interventions, except for imposing enterostomas and laparostomy, whereas in patients at the stage of a common peritonitis, regardless of the compensation of the functional state, an operation after The elimination of obstruction ended with an overlay of entero and laparostom. In addition, technical improvements (probe for intubation) and modifications (enterostomy and laparostomy) are supplemented with corrective medication therapy to improve the results of surgical treatment. Conclusions. The proposed algorithms of patient management for AOSI before surgery, intraoperative enhancement and postoperative corrective therapy have made it possible to significantly optimize the surgical treatment of this group of patients and to accelerate the recovery of motor and evacuation function of the digestive canal in the early postoperative period.
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