Hamidov A. Clinico-experimental substantiation of surgical interventions at peritonitis with the account of spike formations in an abdominal cavity

Experimental researches is established, there is a close interrelation between changes in system of coagulation of blood, intensity of peroxidation of lipids processes and phospholipase activity А2, structure of the basic classes of lipids at peritonitis. Under the influence of introduction of preparations with antioxidatic and anticoagulant action in a combination with opened EHF (extremely high frequencies) irradiation the coagulative potential of blood in the general blood flow was not only normalised, but also authentically varied towards a hypocoagulation in early terms of research, intensity of peroxidation of lipids in blood was normalised in 3 days after operation. In the clinical section of work demonstrated that the general strategy of treatment of peritonitis should include pathogenetically proved actions referred on correction of disorders of coagulating system, blocking of processes of free radical peroxidation of lipids, and also disturbances of lipide structure of blood. Surgical tactics of treatment of patients with widespread forms of peritonitis depending on degree of risk of development of an incompetence of seams of anastomoses is developed. There are developed and introduced in clinical practice the methods of stage laparoscopic sanations in a combination with intracorporal EHF irradiation, intraoperative prophylaxes of adhesive formation in an abdominal cavity, and also medicamental correction in the scheme of postoperative treatment. Introduction of techniques of preventive measures of spike formation, sparing video endoscopic sanations of an abdominal cavity in a combination with intracorporal EHF irradiation, together with stage surgical interventions at resections of an intestine in the conditions of a peritonitis allows to stabilise a condition of the patient that conducts to reduction of quantity of postoperative complications in 2,4 times, and allows to decrease a lethality of the given category of patients in 1,6 times. Integrated indicator of a physical component of health at patients of the basic group in 1,3 times (p <0,05), and a mental component - in 1,16 times above, than in comparison group.