ABSTRACT
Acute erosive lesions of upper parts of gastrointestinal tract with bleeding aggravate severe burn trauma, postoperative period after extensive surgeries and is the often component of polyorganic insufficiency syndrome. Gastric secretion in patients with severe burn trauma and neurotrauma was studied. Decrease of gastric secretory function due to central paresis of gastrointestinal tract and reflux of bile into stomach was seen in majority of patients with neurotrauma and acute gastric ulcers. On the contrary, in patients with burn shock increase of acid-secretory function of stomach was revealed. Schemes of prophylaxis and treatment of acute ulcers were developed. They included antacid therapy (for patients with increased secretion), regulators of motor-evacuatory function of stomach and intestine (for patients with paresis), drugs increased regenerative properties of mucosa, early enteral nutrition with balanced mixtures. This treatment in combination with hemostatic therapy and cure of main disease permitted to reduce number of gastroduodenal bleedings and lethality in these patients.
Subject(s)
Critical Illness , Gastrointestinal Hemorrhage/etiology , Burns/complications , Craniocerebral Trauma/complications , Gastric Acid/metabolism , Gastrointestinal Hemorrhage/physiopathology , Gastrointestinal Hemorrhage/prevention & control , Humans , Intestinal Obstruction/etiology , Intestinal Obstruction/physiopathology , Peptic Ulcer/etiology , Peptic Ulcer/physiopathology , Peptic Ulcer/prevention & control , Peptic Ulcer Hemorrhage/etiology , Peptic Ulcer Hemorrhage/physiopathology , Peptic Ulcer Hemorrhage/prevention & controlABSTRACT
A success in treatment of acute ulcerations of the upper parts of the gastrointestinal tract in patients with a severe neurosurgical pathology can be achieved only with a complex approach to treatment of the intensive care patients. The application of antiulcerous medicines in combination with pyrokinetics and medicines improving the regeneratory ability of the gastrointestinal tract mucosa allowed to considerably decrease risk of the development of gastroduodenal bleedings against the background of erosive-ulcerous lesion of the mucosa. The endoscopic methods of arresting bleedings in such patients in combination with the correction of homeostasis by infusions and local hemostatic therapy in most cases result in reliable hemostasis of the upper parts of the gastrointestinal tract. The program of active measures is completed with the early enteral feeding with balanced nutritional mixtures.
