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North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
The article discusses the main aspects of the pathogenesis of peritonitis, determining treatment policy with a focus on the role of enteral insufficiency and increased intra-abdominal pressure. Analyzed the effect of increased intra-abdominal pressure on the morphological changes in the tissues of the abdominal wall, diaphragm, chest and abdominal cavities. The concepts of 4intra-abdominal hypertension and its influence on the state of the lymph circulation, venous and arterial blood supply and the role of intra-abdominal hypertension, as the starting point in the development of multiple organ failure, leading to the 4intra-abdominal hypertension syndrome, which occurs in 16% of patients with widespread peritonitis. Methods of correction intra-abdominal hypertension discusses the role of the nazointestinal decompression, epidural anesthesia, laparostomy with dosage correction of intraabdominal pressure. It is shown that the decompression of the abdomen is the only way to treat the «intra-abdominal hypertension syndrome», which leads to a decrease in mortality in peritonitis.
Key words: widespread peritonitis, abdominal perfusion pressure, intra-abdominal pressure, syndrome of intra-abdominal hypertension.
Contact: Y.V. Grebtcov Tel. 8-911-934-05-51 e-mail: Grebcov_dok@mail.ru
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