SANITATION OF THE ABDOMINAL CAVITY IN WIDESPREAD PERITONITIS
Summary. Purpose. Study of the effectiveness of permanent transmembrane peritoneal dialysis in “semi-closed” management of the abdominal cavity (BP) in patients with advanced purulent peritonitis (APP).
Materials and methods. The results of treatment of 63 patients with APP with “semi-closed” administration in the abdominal cavity (BP) were analyzed. Depending on the features of BP drainage, patients with RGP were divided into two groups: comparison group (CG) — 31 patients who used traditional methods of abdominal drainage and the main group (MG) — 32 patients who underwent permanent peritoneal surgery in the postoperative period. dialysis through an artificial semipermeable membrane.
Results and discussion. A study of the relationship between the levels of molecules of average weight in spent dialysis solution with the severity of multiorgan failure (MF) on the SOFA scale using Spearman’s correlation analysis revealed an average degree of correlation: 1 day after surgery - r = 0.63 (p = 0.01), for 3 days — r = 0.75
(p = 0.001). The average degree of correlation between these indicators can be explained by the fact that in addition to endotoxicosis, the severity of MF in the next day after surgery also affects surgery. This is also confirmed by the increase in the correlation coefficient by 3 days, when the degree of influence of the operating aid on the severity of MF decreases.
The postoperative period was complicated in 14 (22.2 ± 5.2 %) patients with APP: in CG in 10 (32.3 ± 8.4 %) cases in MG - in 4 (12.5 ± 5.8 %) p = 0.059). Mortality of patients with APP at “semi-closed” management of an abdominal cavity made 19,0 ± 4,9 %: in MG — (25,8 ± 7,9) %, in MG — (12,5 ± 5,8) % (p = 0,179).
Conclusions. The proposed method of peritoneal dialysis reduced the absolute risk of postoperative complications in patients with advanced purulent peritonitis by 19.8 %.
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