[Enteral therapy of the syndrome of intestinal insufficiency in patients with peritonitis]. / Enteral'naia terapiia sindroma kishechnoi nedostatochnosti u bol'nykh s peritonitom.

Sixty five patients with peritonitis were examined and divided into two groups. The operative intervention in all the patients included transnasal intubation of the small intestine. The basic enteral therapy used in the first group of patients was made with the glucose-saline solution and transition to a balanced polysubstrate mixture "nutrient standard" with the increasing concentration. For the patients of the second group a special program was developed for enteral therapy in which glutamine and pectine were included in the glucose-saline solution as well as nutrient mixtures containing middle chain triglycerides. Active decompression of the small intestine followed by the enteral administration of the nutrient mixtures facilitated quicker correction of the intestinal insufficiency in patients with severe forms of peritonitis.

[Activation of the processes of lipid peroxidation in the small-intestinal mucosa and liver in peritonitis and possible ways of their correction by a complex infusion-detoxification therapy]. / Aktivatsiia protsessov perekisnogo okisleniia lipidov v slizistoi tonkoi kishki i pecheni pri peritonite i vozmozhnye puti ikh korrektsii kompleksnoi infuzionno-detoksikatsionnoi terapiei.

Possibilities of lipid peroxidation (LPO) correction by infusion-detoxication therapy in peritonitis were studied in an experiment on 160 white rats and during clinical treatment of 88 patients with general peritonitis. It was shown that peritonitis development in rats was attended by an increase of LPO products--malonic dialdehyde and diene conjugates, in the hepatic tissue and small intestine mucosa, while the activity of antioxidant defense elements--superoxide dismutase and fat-soluble antioxidants, decreased. It was noted that LPO became normal after intravenous administration of exogenous superoxide dismutase (6 mg/kg) and the blood substitute Mafusol containing Krebs cycle substrate--sodium fumarate (9 ml/kg). Inclusion of Mafusol into the combined therapy of patients with general peritonitis contributed to the reduction of malonic dialdehyde and diene conjugate levels in the blood, normalization of its acid-base state, diminution of medium mass molecule content. Similar normalization of LPO was not recorded when lactosol was used. It has been concluded that blood substitute Mafusol used in the combined therapy of patients with general peritonitis significantly raises the treatment effectiveness.