Yaremenko S. Early diagnosis and indications for surgical treatment of necrotic enterocolitis in newborns

Object – course of necrotic enterocolitis in newborns of different gestational age; goal – to improve the results of treatment of necrotic enterocolitis in newborns by improving the methods of early diagnosis of the disease based on comprehensive clinical and instrumental studies and an algorithm for determining indications for surgical intervention; methods – anthropometric, clinical, biochemical, cytoscopic, microbiological, radiation, near-infrared spectroscopy, histopathological, statistical; results – for the first time, indicators of visceral regional oxygen saturation of tissues in newborns with necrotic enterocolitis were studied for the first time, the dynamics of changes at various stages of necrotic enterocolitis was studied; it was found that indicators of visceral regional tissue oxygen saturation in full-term and premature newborns change with the onset and progression of necrotic enterocolitis and can be used to assess the severity of intestinal damage and the extent of the inflammatory process in the intestine with necrotic enterocolitis; it was found that a decrease in the visceral regional oxygen saturation of tissues in newborns with necrotic enterocolitis directly correlates with the stages of the disease, which made it possible to determine the staged course of necrotic enterocolitis and to propose a new algorithm for its diagnosis and treatment; It is proved that low average indices of visceral abdominal regional tissue oxygen saturation in newborns of 1-7 days of life allow us to attribute them to the risk group for the development of complicated necrotic enterocolitis; an action algorithm is proposed that allows a differential approach to the methods and terms of surgical treatment of newborns with necrotizing enterocolitis and predicting the course of the disease; the need for short-term preoperative preparation and early surgical intervention in patients with progressive necrotizing enterocolitis is substantiated; a prognostic model for assessing the effectiveness of surgical treatment of necrotic enterocolitis in children was developed and the parameters of its clinical value were investigated; branch – medicine.