Affiliation:
1. State Autonomous Public Health Institution «Republican Clinical Hospital» of the Ministry of Health of the Republic of Tatarstan
2. State Autonomous Public Health Institution «Republican Clinical Hospital» of the Ministry of Health of the Republic of Tatarstan; Federal State Budgetary Educational Institution of Higher Education "Kazan State Medical University" of the Ministry of Health of Russian Federation
3. Federal State Budgetary Educational Institution of Higher Education "Kazan State Medical University" of the Ministry of Health of Russian Federation
Abstract
The article presents the results of a retrospective study of the intestinal lavage (IL) with saline enteral solution (SES) effectiveness for the treatment of dynamic intestinal obstruction in acute forms of pancreatitis and pancreonecrosis. Objective: to study improve the results of patients treatment in intestinal paresis by various forms of acute pancreatitis, using IL lavage with the use of SES. Materials and methods. The study included 81 patients: 56 (69.1 %) men and 25 (30.9 %) women, average age 59.3 ± 13.4 years, who were hospitalized in the clinic at different times from the onset of the disease: from 24 hours to 7 days. Patients were divided in two groups: 1st group (46 people) included patients who started IL for the first 3 days after the onset of the disease; 2nd group (35 people) consisted of patients who started IL after 3 days of the disease, 30 patients of 2nd grouphad surgery before IL. Results. Prokinetic effect of IL in gastrostasis and dynamic bowel obstruction improve the quality of conservative treatment (up to 78.3 % in 1st group and 37.1 % in 2nd group); avoid open surgical interventions (up to 6.5 % in 1st group, up to 37.1 % in 2nd group), carry out decreasing invasive effects of drainage of limited focus (in 15.2 % of patients in 1st group, 42.9 % in 2nd group); eliminate the phenomen of gastrostasis within 3 days after IL in both groups. Reduction/elimination of the phenomen of dynamic intestinal obstruction after IL within 24 hours (up to 73.8 % in 1st group, up to 97.1 % in 2nd group), allowed to start early enteral nutrition within 48 hours (in 73.9 % of patients of 1st group, up to 42.8 % patients of 2nd group). Conclusions. Early using of intestinal lavage in the complex therapy of acute forms of pancreatitis is safe and effective and reduces the number of purulent-septic complications, prevents the development of multiple organ failure, reduces the overall mortality, prepares the intestine for early enteral nutrition.
Publisher
RPO Surgical Society - Wound and Wound Infections
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