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Диагностика и лечение послеоперационного перитонита

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AeEAAIINOEEA E EA*AIEA IINEAIIA?AOeEIIIIAI IA?EOIIEOA

N.Ae. Aoaaa, I.?. Aaaeoeeaaa.

Iaie aiaeece?iaaiu enoi?ee aieacie 162 aieueiuo a aic?anoa io 18 aei 80
eao, ea/eaoeony a eeeieea ii iiaiaeo iineaiia?aoeeiiiiai ia?eoiieoa
(II), aicieeoaai iinea iia?aoeee ia i?aaiao a?thoiie iieinoe ca
iineaaeiea 22 aiaea (1976-1997). Ioae/ei auei 114 (70,4%), aeaiuei – 48
(29,6%). II ?acaeeny iinea iia?aoeee: ii iiaiaeo ino?ie eeoa/iie
iai?ioiaeeiinoe – o 50 (30,8%) aieueiuo; ia aeaeoaeea e ieuaaiaea – o 42
(25,9%); ia ia/aie e aeae/iuo iooyo – o 35 (19,7%); ia oienoie e i?yiie
eeoeao – o 25 (14,2%); aiiaiaeyeoiiee – o 5 (3,1%); ii iiaiaeo
iaiano?aeueiuo ?aiaiee i?aaiia a?thoiie iieinoe – o 5 (3,1%) aieueiuo.
Iaeaieaa /anoi(75%) II ?acaeaaeny aneaaenoaea ianinoiyoaeueiinoe oaia
aianoiiicia, iaeiaeaiiuo ia aeaeoaei/ii-eeoa/iue o?aeo e aeae/iua iooe.
?acaeoea II niinianoaiaaee oaeoe/aneea iia?aoeeiiiua ioeaee:

a) ia i?iaiaeeeanue aeaeiii?anney aeaeoaeea, eeoa/ieea e iiaieaeiiaay
aeieaaea a?uaeaae;

a) ia?aioeaieaaeanue aeecianiiniaiinoue aeano?aiaoee?iaaiiie eeoee, iia
ia ?acaoee?iaaeanue eee i?iecaiaeeeanue “yeiiiiiay ?acaeoeey”;

a) aneaaenoaea iaaeinoaoi/iie ?aaecee a?thoiie iieinoe inoaaaeenue
ia?aniiciaiiuie caai?io, aioo?aiiaa ouaieaiea eeoee, aeaoaeou noaiie
aeaeoaeea, eeoie, iauaai aeae/iiai i?ioiea e o.ae.;

a) i?e caai?ioa e iae?ica neaiiaeaeiie eeoee eee iieiie iaoo?aoeee a?
iiooieueth, i?iecaiaeeee ia?ae/ioth ?acaeoeeth n iaeiiiiiaioiui
iaeiaeaieai aianoiiica iaaeaeo eiioeaie eeoee;

ae) iaaeinoaoi/ii naie?iaaeanue e iai?aaeeueii ae?aie?iaaeanue a?thoiay
iieinoue e o.ae.

Eeanne/aneia oa/aiea II, nii?iaiaeaeathuaany ino?ie ea?oeiie ia?oi?aoeee
iieiai i?aaia, a ianoiyuaa a?aiy ano?a/aaony an? ?aaea e ?aaea. O
aieueoeinoaa aieueiuo II i?ioaeae aoeie/ii, noa?oi ia oiia ia?aianaiiiai
oyaeaeiai iia?aoeaiiai aiaoaoaeuenoaa e i?iaiaeeiie eioaineaiie oa?aiee.

Naiaa?aiaiiay aeeaaiinoeea II e onoaiiaeaiea iieacaiee e ?aeaia?ioiiee –
o?oaeiay caaea/a a nayce n ianiaoeeoe/iinoueth neiioiiia caaieaaaiey. A
iniiaiii i?eoiaeeony i?eaioe?iaaoueny ia ia?anoathuaa oooaeoaiea iauaai
ninoiyiey aieueiiai a ?aiiai iineaiia?aoeeiiiii ia?eiaea, au?aaeaiiue
aieaaie neiae?ii ianiio?y ia i?iaiaeeioth aiaeueaaceth, oii?iue ia?ac
eeoa/ieea, iaiiaeaeathueeny eiina?aaoeaiui ia?ii?eyoeyi e oaoeea?aeeth.
A iniiaa aeeaaiinoeee II eaaeeo oiaiea oe?o?aa ?aaeno?e?iaaoue,
aiaeece?iaaoue, i?aaeeueii iauynieoue aicieeathuea ioeeiiaiey a oa/aiee
iineaiia?aoeeiiiiai ia?eiaea. Yoi oiaiea iniiauaaaony ia iinoiyiiii
ee/iii iaaethaeaiee ca ninoiyieai aieueiiai, iauaeoeaiae ioeaiea anaai
eiiieaena eciaiaiee, i?ienoiaeyueo a ninoiyiee iaoeeaioa,
nenoaiaoe/aneii eaai?aoi?iii eiio?iea. Aaaeiuie ?aiieie neiioiiaie II
yaeythony: /anoue neaaue ioeuen, ia niioaaonoaothuee oaiia?aoo?a oaea.
acaeooea aeeaioa, ia?anoathuee iaoai?eci, ia eeeaeaee?othueeny
eiina?aaoeaiuie ia?ii?eyoeyie, aieaciaiiinoue aeeaioa, iai?yaeaiea
iuooe, yeoi?ey eee aeai?anney, aanniiieoea, aeaaeaea, eeioa, oioiioa,
?aioa, aeaaaia?aoeaiioiene/aneea e aeioeie/aneea eciaiaiey e?iae. Ethaua
ioeeiiaiey io ii?iaeueiiai oa/aiey iineaiia?aoeeiiiiai ia?eiaea aeieaeiu
aucaaoue o?aaiao e o?aaotho iacaiaaeeeoaeueiuo aeaenoaee ii eo
iauyniaieth e ei??aeoeee. Iiaeic?aiea ia ?acaeoea ia?eoiieoa iinea
iia?aoeaiiai aiaoaoaeuenoaa ia i?aaiao a?thoiie iieinoe yaeyaony
aeinoaoi/iui iniiaaieai aeey i?eiaiaiey o aieueiiai niaoeeaeueiuo
iaoiaeia enneaaeiaaiey. Eciaiaiea oa?aeoa?a e eiee/anoaa ioaeaeyaiiai ec
a?thoiie iieinoe /a?ac ae?aiaaeiua o?oaee, aaaaeaiiua ai a?aiy
iia?aoeee, eaia?ioeaioac /a?ac iniiaioth iia?aoeeiiioth ?aio eee a
iiaeacaeioiuo iaeanoyo ioo?i aaaaeaiey “uaaeyuaai” eaoaoa?a, ieacuaatho
aieueooth iiiiuue a ?aiiae aeeaaiinoeea II. Iaci?iia e eiio?anoiia
?aioaaiieiae/aneia enneaaeiaaiea i?aaiia a?thoiie iieinoe, eaia?ineiiey,
yiaeineiiey aeaeoaeea e eeoa/ieea, O3E iicaieytho iieo/eoue
aeiiieieoaeueioth e a oiaea a?aiy i/aiue aaaeioth eioi?iaoeeth i
iaaeaaiiieo/ee a a?thoiie iieinoe. Ianiio?y ia yoi, ?aeaia?ioiiey ii
iiaiaeo II auea auiieiaia iinea ia?aie iia?aoeee /a?ac 5 noo. e iicaea o
67,4% aieueiuo.

A eiiieaeniii ea/aiee II, iiieii aaeaeaaoiiai iia?aoeaiiai
aiaoaoaeuenoaa e i?iaaaeaiey o?aaeeoeeiiiie eioaineaiie oa?aiee, iniaia
cia/aiea i?eaeaaaee aioo?ea?aaeaa/iie eioocee eaea?noaaiiuo n?aaenoa,
eae aeaeieciaiaiiiio aunieiyooaeoeaiiio iaoiaeo yiaeieeioaoe/aneiai
ea/aiey. Aeey yoiai anai aieueiui II a eiioea iia?aoeee iinea
ouaoaeueiie naiaoeee a?thoiie iieinoe a ei?aiue a?uaeaeee oiieie eeoee
aaiaeeony e oeene?oaony eaoaooii oiieee oei?aeieeiaue iee?ie??eaaoi?,
eniieuecoaiue iau/ii aeey eaoaoa?ecaoeee iiaeeeth/e/iie aaiu.
Ia?eoa?e/aneee eiiaoe iee?ie??eaaoi?a auaiaeeony /a?ac eaia?ioiiioth
?aio ia?oaeo e oeene?oaony e eiaea iaeiei oaii. *a?ac iaai 2 ?aca a
nooee aaiaeeony eaea?noaaiiay nianue, ninoiyuay ec 500 oun. aae.
aiieoeeeeeia eee ae?oaiai aioeaeioeea oe?ieiai niaeo?a aeaenoaey e
i?aia?aoia, oeo/oathueo iee?ioee?eoeyoeeth e aeiyia?aaoeeo a oeaiyo
eeoa/iie noaiee: 1 ie 1% ?anoai?a AOO, 10 oun. Aae. Aaia?eia, 50 ia
aeae?iei?oeciia, 100 ia eiea?aieneeacu. 100 ie 0,25% ?anoai?a iiaieaeia.

Aeaoaeueiinoue i?e II ca iineaaeiea aiaeu (1988-1997 aa.) ii n?aaiaieth
n i?aaeuaeouei aeanyoeeaoeai niecyeanue ia 14%.

Ioeac oe?o?aa io ?aeaia?ioiiee i?e II ii i?e/eia aaciaaeaaeiinoe,
aania?niaeoeaiinoe, nnueee ia oyaeaeua niioonoaothuea caaieaaaiey e
iiaeeeie aic?ano iaoeeaioa iai?aaiia?ii e yaeyaony a?oaie oaeoe/aneie
ioeaeie, ia?aeathuae aieueiuo ia iaecaaaeioth nia?oue. Oieueei ?aiiaa
iiaoi?iia aaeaeaaoiia oe?o?ae/aneia aiaoaoaeuenoai yaeyaony
nianeoaeueiie ia?ie i?e II, oioy oe?o?ao ia anaaaea eaaei i?aiaeieaoue
ineoieiae/aneee aa?uea?.

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