[Enteral nutrition of patients with a severe trauma]. / Enteral'noe pitanie postradavshikh s tiazheloi travmoi.

An analysis of results of using different kinds of nutritional care of 257 patients with severe injuries has been made. Effects of different variants of the nutritional care were estimated by the character of changes in infusion therapy, dynamics of changes of the content of total protein and albumin in blood of the patients, the endoscopic picture of the upper parts of the gastrointestinal tract in dynamics of the trauma disease. At early terms after trauma a combination of parenteral and enteral methods of feeding is thought to be most rational. The probe nutrition allows the volume of intravenous infusions to be reduced. Enteral nutrition results in a less frequency and degree of errosive-ulcerous damages of the mucosa of the upper parts of the gastrointestinal tract.

[Morphofunctional characteristic of enteral insufficiency and means of nutritional maintenance in casualties with a severe trauma]. / Morfofunktsional'naia kharakteristika énteral'noi nedostatochnosti i sposoby nutritsionnoi podderzhki u postradavshikh s tiazheloi travmoi.

Examinations of 257 casualties were performed at different terms after trauma. The criteria for determination of the degree of enteral insufficiency in patients with traumas were the severity of the injury, the severity of the state, the absorption state in the small intestine and the degree of errosive-ulcerous processes in the upper parts of the gastro-intestinal tract. The clinico-laboratory gradation of the enteral insufficiency was developed according to the severity degree that allows to establish the algorithm of its diagnosing and treatment based on the principle of outstripping therapy of the appearing disorders and to optimize the terms and methods of the nutritional maintenance of the patients with traumas.

[Acute insufficiency of the gastrointestinal tract in patients with severe gunshot injury]. / Ostraia nedostatochnost' organov zheludochno-kishechnogo trakta pri tiazheloi ognestrel'noi travme.

Acute insufficiency of the gastrointestinal tract (GIT) in patients with severe gunshot injuries is an important link of pathogenesis of the polyorganic insufficiency syndrome. The character of the wound, the numerical score objective assessment of the injury severity and severity of the patient's state are considered to be criteria of early diagnosis of a risk of the development of acute insufficiency of GIT. The specific feature of "general" intensive therapy of acute insufficiency of GIT in severe gunshot traumas is the necessary application of regional anesthesia, sympatholytics, anticholinesterase agents and H2-blockers. Intensive "enteral" therapy of acute insufficiency of GIT in severe gunshot wounds includes the measures resulting in improvement of microcirculation, tissue respiration in organs of GIT, decompression of the stomach, local defense of mucosa, detoxication and early enteral balanced nutrition. The described method of treatment of wounded to the stomach used at specialized medical institutions resulted in 6.2 less lethality among this category of patients.