Klymenko Y. The clinical and pathogenetic foundation of change and correction of metabolic homeostasis and prevention of complications in complex surgical treatment of patients with peritonitis (clinical and experimental study)

Dissertation is didicated to scientific substantiation and new solution of the topical task – improvment of results of complex surgical treatment of patients with acute general peritonitis by means of researching mechanisms of endogenic intoxication development at the expense of disturbance of metabolic homeostasis, early indices of liver disfunction and introduction of medical measures directed on their prevention. Changes of functional liver state, disturbance of microelement and metalofermentum homeostasis, lipid peroxidation and antioxidant system were researched. Biodegrading gel was elaborated and its medicinal action in experiment was shown. It ensured surviving of 86,7% and prevented adhesion formation of 85% of rats. Diagnostics of early liver failure development on the basis of indices determination of organo-specific ferments of blood serum as markers of inflammatory process acuteness, cellular membrane state, albumin synthesized, detoxication ureapoiesis and secrete function of liver was substantiated. Elaborated way of complex surgical treatment of patients with acute general peritonitis favoured reduction of lethality from 9,3 % of patients in control group to 4,5% of experimental patients.