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9больных с воспалительными заболеваниями паро-донта / Ю.Г. Чумакова, А.И. Перова, О.В. Мороз, Н.Н. Запорожец // Вюн. стоматологи. - 2001. - № 2. - С.26-28.
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MODERN ASPECTS OF THE TREATMENT OF THE ABDOMINAL CAVITY AGAINST RETAINED
FORMS OF PERITONITIS
Moroz P.,
Department of Surgery №1, PHD, assistant
Kotelban A.
Department of Pediatric Stomatology, PHD, assistant Higher State Educational Establishment of Ukraine «Bukovinian State Medical University»
Abstract
Acute peritonitis is one of the most severe complications in abdominal surgery. The high incidence, unpredictable course, lack of effectiveness of existing methods of treatment - all this determines the relevance and practical importance of this problem. Issues of improving the effectiveness of treatment of acute peritonitis are one of the most difficult problems of abdominal surgery. Despite significant advances in the development of methods for treating such patients, mortality remains high (from 16% to 63%) and has no tendency to decrease. At the present stage there are no absolutely specific methods for the treatment of acute peritonitis. This is due to the diversity of etiological factors, the versatility of pathogenesis, changes in clinical manifestations under the influence of various factors. The method of sanitizing the peritoneal cavity in complex treatment with common forms of acute peritonitis, by supplying oxenovenic antiseptic solutions to the peritoneal cavity under pressure, allows for a rapid progressive decrease in microbial contamination of the exudate, reduce the frequency of intra-ab-dominal complications and increase the effectiveness of treatment of such patients.
Keywords: Acute peritonitis, surgical treatment, "Dekasan", special device.
Introduction. Despite the development of new and improvement of existing methods of surgical treatment, the use of a powerful arsenal of modern intensive care means, the mortality rate with widespread peritonitis remains at a high enough level [2,3,5]. In this regard, in recent years, the attention of surgeons shifted to in-depth study of the pathogenesis of peritonitis in order to develop effective methods for its treatment. Among them, the issue of adequate intra- and postoperative debridement of the wooden cavity as the main element of detoxification remains relevant.
Objective: to improve the efficiency of treatment of patients with advanced peritonitis by providing conditions for maximum removal of microorganisms, including anaerobic, not only from the exudate, but also from the surface of the peritoneum. The object and methods of research. The study included 136 patients with advanced peritonitis.
The results of the study, their discussion. In all patients, the peritoneal cavity is reorganized after the elimination of the cause of peritonitis [1,4,6]. After the evacuation of the existing exudate, the parietal and visceral peritoneum was flushed with an oxygenated antiseptic solution according to the developed procedure.
To do this, in a sealed container with an antiseptic solution ("Dekasan") through a tube with holes placed at the bottom of the can, under pressure, atomic oxygen is introduced, which passes through the solution, oxygenates it, and creates pressure in the pressurized can, provides the solution through a separate tube to the peritoneal cavity.
A stream of solution is successively directed to the parietal and visceral peritoneum, washing away from its surface necrobiotic tissue, fibrin layers, and the washing solution is removed by suction. The jet of the solution, in addition to the washing, cleansing effect, provides microvibration of tissues, a kind of vibratory massage, which helps to improve the blood supply to tissues, stimulates regenerative processes [7,8]. The operation is completed by placing drainage tubes in all sloping areas of the peritoneal cavity, which are connected to a larger diameter pipeline. In the postoperative period, using the developed device for active prolonged sanation, using the infusion mode (Fig.1), we wash the peritoneal cavity with antiseptic solutions, and with the suction mode we remove the exudate (Fig.2) [7,8]. Characteristically, the device operates on an individual closed circuit, does not require constant sterilization of auxiliary elements.
Fig. 1. Washing the peritoneal cavity with antiseptic solutions with a special device.
Fig.2. Suction of exudate from the peritoneal cavity with a special device.
Thus, the positive effect of the proposed method of sanation of the peritoneal cavity with common forms of acute peritonitis is achieved by a combination of the choice of antiseptic, which, besides a wide spectrum of bactericidal action, also has surface-active properties, the antimicrobial effect of which is enhanced by oxygenation of the solution, and the peritoneum is jet treated, which, besides the clearing, washing effect,
provides vibromassage of fabrics. The use of the developed device for active prolonged sanation contributed to the active extra-operative washing of the peritoneal cavity and the rapid progressive reduction of microbial contamination of the exudate.
Conclusion. The positive effect of the proposed method of sanitation is achieved by a combination of antiseptic choice, which, besides a wide spectrum of bactericidal action, also has surface-active properties,
the antimicrobial effect of which is enhanced by oxygenation of the solution, and the peritoneum is treated with a jet, which, in addition to a vibrating massage.
The rehabilitation operation is carried out by actively supplying antiseptic solutions to the peritoneal cavity, supporting their exposure and active evacuation using a device for active prolonged rehabilitation of the peritoneal cavity, allows for a rapid progressive reduction of microbial contamination of the exudate, reduce the incidence of intra-abdominal complications and increase the effectiveness of treatment of such patients.
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2. Filippone A. CT findings in acute peritonitis: a pattern-based approach. Diagnostic and Interventional Radiology. 2015. Vol. 21. № 6. Р. 435-436.
3. Grynchuk F.V. Comparative characteristic of fibrinolytic activity in case of experimental peritonitis and underlying diabetes mellitus / F.V. Grynchuk, A.F. Grynchuk, V.V. Maksimiuk // Мiжнародний ендокринолопчний журнал.- 2017.- Т. 13, № 8.- С. 618-623 DOI: 10.22141/2224-0721.13.8.2017.119281
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8. Полянський 1.Ю., Мороз П.В., Москалюк В.1., Андpieць В.В. Спосiб виконання повторних лапараскотчних мaнiпуляцiй. Патент № 118451 U Укра!ни № u201701711; БДМУ; заявл. 23.02.2017, опубл. 10.08.2017. Бюл. №15. 5 с.
BASIC REGULARITIES OF MORBIDITY, DISABILITY, MORTALITY FROM CARDIOVASCULAR DISEASES AND ARTERIAL HYPERTENSION IN COUNTRIES OF THE WORLD AND IN
UKRAINE
Navchuk I.,
Bukovina State Medical University, Ukraine
Navchuk G.,
Bukovina State Medical University, Ukraine
SobkoD.
Bukovina State Medical University, Ukraine
Abstract
The development, course and prevention of circulatory system diseases, in spite of many years of multidimensional research, remain the most important health problem in the countries of the world and in Ukraine in particular. Not an exception in this nosological group and arterial hypertension, which is the trigger mechanism for almost all pathologies of the heart and blood vessels of a person. Circulatory system diseases are ranked first in Ukraine among all the illnesses taken together.
Keywords: diseases of the blood circulation system, arterial hypertension, morbidity, disability, mortality, rural population.
The problem identified in the title is not new in terms of research and practical implementation, but is not considered to be studied until the end. This is evidenced by the data of the review of the world scientific information flow, as will be discussed further.
Diseases of the circulatory system are the main causes of mortality and disability in most countries of the world, including Ukraine (accounting for almost half of all deaths). The second place in terms of causes of death is cancerous diseases, which exceeds one fifth of all deaths. In developing countries, circulatory system diseases are ranked second among causes of death,
and they account for almost 25%, infectious and parasitic diseases (43%) are in the first place. In highly developed countries, the proportion of infectious and parasitic diseases as causes of death is negligible (less than 1%). Ukraine, on the basis of these parameters, occupies an intermediate position between developed and developing countries. In terms of the proportion of infectious and parasitic diseases, Ukraine is close to highly developed countries, in terms of the proportion of cancers - to developing countries. At the same time, the proportion of circulatory system diseases in Ukraine is the largest and accounts for almost half of all deaths.
