Gnativ V. System and regional oxygen balance at the complicated forms of a stomach and a duodenal gut ulcer: perioperative intensive therapy (clinical and experimental research)

The dissertation is dedicated to the study of the systemic and regional oxygen balance in patients with complicated ulcer disease and to the optimisation of perioperative intensive treatment. It was established that ulcer penetration is accompanied with activation of tissues breathing. In this case the system of oxygen transport to tissues functions in excessive regime. In the case of bleeding ulcer, the critical mark of oxygen privision – is the index of oxygen transport less than 300,0 ml·min-1·m-2, in the case of punching ulcer – less than 380,0 ml·min-1·m-2, in the case of decompensated sthenosis – less than 400,0 ml·min-1·m-2. The intension of tissues breathing in regional level is proportionable to blood circulation and inversly – to age, in the case of bleeding ulcer, the intension of blood circulation correlates with deficit of volume of circulated blood, the coefficient of oxygen utilisation increases. In the case of reactive peritonitis the consuming of oxygen by tissues increases, in thecase of toxic peritonitis – insignificantly decreases, in the case of terminal peritonities – decreases near 60 % from norm. In the case of sthenotic ulcer, the blood circulation, oxygen entrance and its consuming synchronously decrease according to sthenosis degree. The algorithm of perioperative treatment, situated on principles of increasing of oxygen transport to the tissues, metabolism decreasing and regional hypoxia liquidation with prolonged sthomach oxygenotherapy, was worked out. Like a result – the possibility of prevention of forming and treatment of stress ulcers and peptic ulcers, possibility of restoration of functional condition of gastro-intestinal tract and shortening of treatment period for 1,5 days.