Bokarev Mikhail Igorevich (Doctor of Medical Sciences, Professor, I.M. Sechenov First Moscow State Medical University)
Mamykin Alexander Igorevich (Candidate of Medical Sciences, Assistant, I.M. Sechenov First Moscow State Medical University)
Alali Khaled Jamal (post-graduate student, I.M. Sechenov First Moscow State Medical University)
Demyanov Andrey Ivanovich (Candidate of Medical Sciences, Associate Professor, I.M. Sechenov First Moscow State Medical University)
Pokrovsky Konstantin Aleksandrovich (Doctor of Medical Sciences, Deputy Chief Physician of the State Medical University named after A.K. Yeramishantsev)
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Introduction. Drainage of the abdominal cavity is an integral stage of surgical intervention in patients with secondary widespread purulent peritonitis (VRGP). An incorrectly chosen method of drainage of the abdominal cavity can contribute to the development of TP and negate all the efforts of medical personnel.
The purpose of the study. To improve the results of treatment of patients with VRGP by optimizing the drainage of the abdominal cavity. Materials and methods. The work included 608 patients with VRGP. The average age is 61.7 ± 17 years. SOFA – 2.6 ± 1.5 points. MIP – 26.3 ± 7.4 points. 211 (34.7%) patients died. To identify the most effective method of drainage of the abdominal cavity, all patients were divided into three groups: the ZD group – drainage by tubular drains, the TL group – open drainage by traditional laparostomy, the ALS group – drainage by active laparostomy (using a vacuum system). The effectiveness of abdominal drainage was assessed by the frequency of TP. The results of treatment were evaluated by the mortality rate.
Comparison of the frequency of tertiary peritonitis and the mortality rate in each group allowed us to assess the effectiveness of the method used for drainage of the abdominal cavity. Results. In the ZD group, the incidence of TP is 41.9%, mortality is 62.8%. In the TL group, the incidence of TP is 36.5%, the mortality rate is 36.5%. In the ALS group, the incidence of TP is 18.3%, mortality is 19.6%.
Conclusions. The conducted study recorded a direct dependence of the results of treatment of patients with VRGP on the effectiveness of abdominal drainage and clearly demonstrated that when choosing the method of drainage of the abdominal cavity, it is necessary to take into account the severity of the purulent process.
Keywords:widespread purulent peritonitis, tertiary peritonitis, laparostomy.
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Citation link:
Bokarev M. I., Mamykin A. I., Alali K. J., Demyanov A. I., Pokrovsky K. A. The effect of abdominal drainage on the results of treatment of patients with widespread purulent peritonitis // Современная наука: актуальные проблемы теории и практики. Серия: Естественные и Технические Науки. -2022. -№04/2. -С. 162-169 DOI 10.37882/2223-2966.2022.04-2.06 |
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