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№2' 2021

SURGERY

International Medical Journal, Vol. 27., Iss. 2, 2021, P. 32−36.

DOI (https://doi.org/10.37436/2308-5274-2021-2-5)

SEPTICOTOXEMIA AND COAGULATION DISORDERS IN ENTERAL INSUFFICIENCY IN PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION

V. T. Zaitsev Institute of General and Emergency Surgery, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Kharkiv National Medical University, Ukraine

At the present stage of discussion of the treatment tactics for the patients with acute intestinal obstruction, the issue of enteral insufficiency syndrome is relevant, the occurrence of which is caused by changes in the intestine secretory, absorption and barrier functions. To analyze the results of treatment of patients with acute intestinal obstruction aggravated by enteral insufficiency syndrome and to identify ways to improve it, 62 patients were examined. It is noted that the most common etiological factors of obstruction were determined by the colon tumors. In the peripheral venous blood flow of patients, coagulation activation with depression of fibrinolysis was recorded, and in the blood flowing from the intestine, the changes in coagulation were observed according to the type of disseminated intravascular coagulation syndrome. The development of systemic endotoxemia of intestinal origin was clearly correlated with the clinically manifested syndrome of disseminated intravascular coagulation, which allowed to consider endotoxin as an etiological factor of this syndrome. The results of this study showed that in the examined patients the development of enteral dysfunction led to septicotoxemia. In this case, its toxic and mediator components are detected on the background of stress immunodeficiency and act independently of each other. The increase in the severity of the enteral insufficiency syndrome is accompanied by the changes in the coagulogram of patients: in the degree 2 the signs of hypercoagulation are more often observed, and in the degree 3 this was hypocoagulation. However, as a result of statistical analysis of hemostasis, depending on the severity of the correlation syndrome, their changes were not detected. This indicates an indirect relationship between coagulogram parameters and the processes occurring in ntestines of these patients, which indirectly demonstrates the role of the liver in buffering changes in intestinal circulation and systemic hemostasis.

Key words: acute intestinal obstruction, enteric insufficiency syndrome, septicotoxemia.

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