Nepomnyaschiy V. Complex diagnostics and treatment of gastrointestinal obstruction (experimental and clinical dosage).

Dissertations on the scientific level of Doctor of Medical Sciences for specialties 14.01.03 - surgery. - Kharkiv Medical Academy of Postgraduate Education, Kharkiv, 2020. In an experiment on the model of mechanical ileus, aseptic paresis of the intestine and paresis of the intestine against the background of peritonitis, morphological differences in the structure of the intestinal wall were established, which formed the basis for the development of ultrasound criteria reflecting the signs of aseptic paresis, peritonitis and mechanical ileus. On the basis of morphologically substantiated criteria, a classification of the degree of compensation for the contractility of the intestinal wall in mechanical ileus is proposed: compensated, subcompensated, decompensated, which allows you to determine the need to perform bowel decompression and choose its method. The model of mechanical ileus shows the differential ability of the inflamed intestinal wall to accumulate in itself cephalosparins and fluoroquinolones of the third generation, metronidazole and carbopenems. The experiment has shown the ability to restore the mesothelium layer in deserosed areas during autoperitoneal transplantation. The obtained results of experimental studies formed the basis for the differential diagnosis of various types of ileus in the clinic in 549 patients, the improvement of the method of surgical interventions and antibacterial therapy, which made it possible to reduce the amount of GSO from 34.1% to 17.4% (p <0.05), postoperative mortality from 18 to 3.8% (p <0.05). Key words: acute intestinal obstruction, ultrasound examination, antibiotic therapy, postoperative paresis, experimental ileus, intestinal decompression, extensive deserosis.