Povelychenko M. Optimization of surgical treatment of patients with abdominal sepsis in view of violations of microsomal oxidation.

Dissertation is devoted to the pathogenesis of AS complications and optimization of surgical treatment of patients with AS by selecting individualized treatment and tactical approach based on prediction of treatment outcomes and possible occurrence of postoperative complications. The aim of the study was to improve the results of surgical treatment of patients with AS by individualization of medical tactics taking into account disfunction of microsomal detoxification system. In the experiment, during the formation of ischemia-reperfusion syndrome of the small intestine, indicators of microsomal oxidation were examined on the background of glycoprotein ?-globulin fraction serum of human blood and carnitine, which while protecting cytochromes P450 and b5 from oxidative damage, support the active functioning of the electron transport chain, thus improving energy supply of cells by reducing the rate of lipid peroxidation and changing in the rate of endogenous respiration. Use of improved surgical tactics and RL in patients with severe AS and ITSH "on demand" (42 patients), was accompanied by significantly lower rates of mortality (38.1%) than in patients who underwent lung cancer "program" (27 patients), mortality (55.6%). Proposed individualized treatment and tactical approach to the complex treatment of patients with AS allowed to reduce the number of secondary postoperative complications by 26,9%, mortality - by 5.6%.