[Mutual role of factors of endotoxicosis and intra-abdominal hypertension syndrome in pathogenesis of abdominal sepsis].

The mutual role of the main factors of endotoxicosis and intraabdominal hypertension syndrome (IHS) were studied in pathogenesis of abdominal sepsis, basing on analysis of the treatment results in 156 patients, suffering this disease. The contents of neutrophils, macrophages, interleukins (IL-6, IL-10) were studied in peritoneal exudate as the indices of the source of inflammation in abdominal cavity. There was established the mutual strengthening of the endotoxicosis and IHS factors, what causes the clinical signs of the organ dysfunction, determines the course severity and outcome of pathological process in the organism. Such approach to pathogenesis of abdominal sepsis permits in time and adequately to elaborate the certain program of treatment in the patients.

[Pathogenetic aspects of intra-abdominal hypertension in patients with abdominal sepsis].

The authors had offered the original estimated system with the points calculation, basing on analysis of the examination and treatment results in 150 patients, suffering abdominal sepsis. The system, alike others, includes not only determination of the inflammation factors and indices of endotoxicosis, but as well as those, concerning intraabdominal pressure, the anterior abdominal wall rigidity and the tissues elasticity. Among the important indices, needed to determine, were considered those, which categorize the syndrome of intraabdominal, intrathoracic and microregional hypertension as well as the mechanisms of endotoxicosis pathogenesis. The authors recommend to use the indices of pathological consequences of this two factors while doing assessment of the abdominal sepsis severity.

[The significance of intestinal decompression and lavage in the treatment of ileus and peritonitis].

The results of treatment of 67 patients, admitted to the hospital clinic for the spread peritonitis and ileus were studied. In 37 of them (main group) the intestinal decompression and hypothermic lavage was performed, in 30 (control group)--intestinal decompression only. The operation character and intensive therapy volume in patients of both groups were similar. In conduction of hypothermic intestinal lavage the accelerated restoration of intestinal peristalsis was noted, as well as the peritonitis and intoxication symptoms elimination. Duration of treatment of patients in stationary in the main and control groups had constituted, accordingly (11.6 +/- 0.73) and (16.8 +/- 1.03) days, lethality--8.1 and 13.8, frequency of complications--10.8 and 30%.