ABSTRACT
The article deals with problems of performing detoxication in complex treatment of acute ileus. A method of plasmapheresis is proposed for treatment of patients with a pronounced intoxication syndrome. Criteria for the estimation of the patient's state are presented which are considered as indications for extracorporal detoxication and for effectiveness of plasmapheresis both by clinical criteria of the estimation of the patient's state and by laboratory findings. High efficiency of the method is shown in complex treatment of patients with acute ileus with a pronounced intoxication syndrome.
Subject(s)
Intestinal Obstruction/surgery , Plasmapheresis , Toxemia/therapy , Acute Disease , Adult , Aged , Female , Humans , Intestinal Obstruction/complications , Male , Middle Aged , Postoperative Care , Toxemia/etiologyABSTRACT
The results of examination and treatment of 216 patients with acute intestinal obstruction of benign genesis are discussed. The values of blood plasma toxicity and the values of hemostasis determined before and after the operation were compared. Intoxication of patients was found to increase in the postoperative period. Its increase was appraised according to the duration of the disease. The causes of mortality were analysed and the risk factors of intoxication increase in the postoperative period were revealed. The authors suggest a classification of the phases of intoxication in patients with acute intestinal obstruction on the basis of the degree of intoxication and the condition of homeostasis.
Subject(s)
Intestinal Obstruction/complications , Intestine, Small , Sigmoid Diseases/complications , Toxemia/etiology , Acute Disease , Adolescent , Adult , Female , Hemoperfusion , Humans , Intestinal Obstruction/blood , Male , Middle Aged , Sigmoid Diseases/blood , Toxemia/therapyABSTRACT
Experiments were conducted on 75 rabbits to study the efficacy of endolymphatic administration of aceclidine, obsidan, and cerucal for stimulation of the intestine in its experimental paresis. The stimulating effect of the pharmacological agents was found to be of a longer duration in endolymphatic that in intravenous administration. This allowed endolymphatic pharmacological stimulation of the intestine to be suggested for the use in abdominal surgery.
Subject(s)
Abdomen/surgery , Gastrointestinal Motility/drug effects , Intraoperative Care/methods , Metoclopramide/administration & dosage , Propranolol/administration & dosage , Quinuclidines/administration & dosage , Animals , Drug Evaluation, Preclinical , Emergencies , Female , Injections, Intralymphatic , Injections, Intravenous , Male , Rabbits , Stimulation, ChemicalABSTRACT
Hemosorption and endolymphatic pharmacotherapy was included in the complex of treatment in 65 patients operated upon for spreaded forms of peritonitis and acute ileus. Hemosorption was performed within 12-24 h after operation, pharmacological agents (Aceclidine++, Cerucal, Obsidan) were introduced by antegrade endolymphatic infusions 4-6 h after hemosorption. The investigations have shown that in this case there rapidly appears intestinal peristalsis which is maintained not less than for 10-12 hours and in great part of patients it was completely recovered. Multiple stimulations by traditional methods were necessary in the control group to restore peristalsis. The combination of hemosorption and endolymphatic therapy may be recommended as an effective complex for the struggle against intestinal paresis in peritonitis and acute ileus in the postoperative period.
Subject(s)
Gastrointestinal Motility/physiology , Hemoperfusion , Intestinal Pseudo-Obstruction/surgery , Metoclopramide/administration & dosage , Peristalsis/physiology , Peritonitis/surgery , Propranolol/administration & dosage , Quinuclidines/administration & dosage , Acute Disease , Aged , Female , Humans , Injections, Intralymphatic , Intestinal Pseudo-Obstruction/physiopathology , Male , Middle Aged , Peristalsis/drug effects , Peritonitis/physiopathology , Postoperative CareABSTRACT
The effect of postoperative hemosorption (HS) on the pulmonary functions in 55 patients with acute ileus was studied. The severity of the state of the patients was conditioned by intoxication leading to ++over-stress of the non-respiratory pulmonary functions and development of I-II stage acute respiratory failure. HS contributes to detoxication of an organism, but is accompanied by the mean 30-35% loss of the oxygen on the adsorbent resulting in development of arterial hypoxemia. Thus, HS should be added with spontaneous breathing with positive pressure at the end of expiration.
Subject(s)
Hemoperfusion , Intestinal Obstruction/surgery , Respiration/physiology , Respiratory Insufficiency/therapy , Toxemia/therapy , Acute Disease , Adult , Female , Humans , Intestinal Obstruction/complications , Intestinal Obstruction/physiopathology , Male , Middle Aged , Positive-Pressure Respiration , Postoperative Care , Respiratory Insufficiency/etiology , Toxemia/etiology , Toxemia/physiopathologyABSTRACT
The fibrin-stabilizing factor (XIII factor of the hemostasis system) was studied in 101 patients with unresolved mechanical jaundice. It was first shown that this disease is characterized by a statistically significant decrease of the FSF to 56-68%. The decrease of the XIII factor is prognostically unfavourable and points to the development of hepatic insufficiency. The experience has shown that in critical patients with the content of FSF lower than 30% it is expedient to perform decompressive procedures such as cholecystostomy, percutaneous transhepatic cholangiostomy, endoscopic papillotomy etc. as well as transfusion of fresh frozen plasma and hemosorption if there is no contraindications. In patients with FSF lower than 50% before operation it is sufficient to perform hemosorption and transfusion of fresh frozen plasma.
Subject(s)
Cholestasis/blood , Factor XIII Deficiency/etiology , Factor XIII/analysis , Adult , Aged , Blood Transfusion , Cholestasis/surgery , Factor XIII Deficiency/therapy , Female , Hemoperfusion , Humans , Male , Middle Aged , Postoperative Care , Preoperative Care , PrognosisABSTRACT
The article discusses the results of complex surgical treatment of 108 patients with acute intestinal obstruction which was caused by benign lesions in 64 and by malignant tumors of the rectum in 44 patients. Twenty-three persons (21.2%) died after palliative and radical operations. The main causes of death were intoxication (52.2% of fatal cases) and peritonitis (26.1%). Hemosorption is the most effective measure for the prevention and treatment of the endogenous intoxication syndrome in the postoperative period. A brief therapeutic effect or inefficacy of hemosorption is evidence of persistence of the pathological process in the abdominal cavity.
