Khabusev V. There is an objective estimation of weight of the state of patients with widespread peritonitis at determination of the program of laparosanation.

Object of the study: diffuse peritonitis (DP). Purpose of the study: improvement of the results of surgical treatment of patients with DP by grounding a programme of laparosanitations with regard for an objective assessment of the state severity. Methods of the investigation: clinical, clinical-laboratory, biochemical, radiological and statistical ones, mathematical analysis. Theoretical and practical results: the use of the abdominal cavity index makes it possible to objectively assess the expression rate of the local manifestations of peritonitis, to determine the efficacy of the surgical sanitation and the number of its procedures. The employment of Manheim index of peritonitis and the scale for assessing acute sepsis make it possible to objectively assess the dynamics in the disease course, to assess the severity of the patient’s state, and to plan a mode for performing laparosanitations. The use of the developed algorithm for establishing indications for the beginning, continuation and discontinuation of laparosanitations in a programme of surgical treatment of DP patients on the basis of scales for an objective assessment of the state severity makes it possible to bring an element of subjectivity to minimum when revealing indications for relaparotomy. The establishment of haematological indices and the use of a mathematical model for prognosticating a course of peritonitis provide a choice of the optimum tactics of the treatment. Novelty: it was found out that the results of treating DP patients depended upon the expression rate of an inflammatory process in the abdominal cavity, a degree of homeostatic disturbances, and the development of multi-organ insufficiency, whose objective assessment is possible on the basis of using special scales. The efficacy of the abdominal cavity index, Manheim index of peritonitis and ASSES scale was estimated for assessing local and systemic manifestations of peritonitis, when a programme of laparosanitations is chosen. It was proved that haematological indices reliably reflected a degree of the state severity in patients with DP. For the first time, a method of mathematical prognostication of peritonitis course was developed, thereby making it possible to assess the patient’s state severity at all the stages of his treatment objectively and in an individual way. For the first time, an individualized technique was suggested for planning laparosanitations at surgical treatment of patients with DP. Degree of introduction: results of the research were introduced and are used in the work of surgical departments of health establishments in the City of Kharkiv (City Multi-Type Hospital No. 17, City Multi-Type Hospital No. 18, Railway Hospital of Kharkiv Station), Liubotin Town Hospital, Shakhty Central District Hospital of Donetsk Region. Sphere of application: medicine, surgery