Search

Experimental comparative morphological investigation of hemomicrocirculation bed (HMCB) of the small and large bowel wall was performed in dynamics of an acute serous peritonitis. Spreaded aseptic peritonitis was simulated using injection of 5 ml of gamma-caraginen (Sigma, USA) in 1 ml of isotonic solution of sodium chloride. On the early stage of peritonitis (in 12 h from beginning of the experiment) in mucosa of small bowel nonsignificant venuls dilatation and the capillary lumen reduction were observed. In 1 day (reactive stage of peritonitis) in mucosa the quantity of capillars have had reduced significantly, comparing with such observed previously. On the 2-nd day (toxic stage of peritonitis) some capillary dilatation in intestinal villi and crypts coexistant with the blood rheology disorders in a form of stasis, change in permeability of the vessels walls, predominantly of the venous, was noted. On the 3-d day (late stage) the arteriol's spasm have had reduced, capillary paralytic dilatation was revealed. The staged course of experimental peritonitis with the HMCB changes, characteristic for every stage, was confirmed, basing on analysis of the investigation result.

Individual values of clinic-laboratory indices were analyzed in 125 patients, suffering severe forms of an acute pancreatitis (AP). In the early postoperative period there were analyzed 65 indices: clinical analysis of the blood, 24 hematological indices, biochemical analysis of the blood, coagulogram, estimates according to the ASSES, APACHE II, SAPS, SAPS II, SAPS III scales. There was established, that in 83.1% of patients in severe forms of an AP the ratio or the values difference of clinic-laboratory indices in dynamics of postoperative period are depicted according to the "Golden section" rule with deviation no more than 10-15%. In the patients, suffering sterile pancreonecrosis, in comparison with those, suffering infected pancreonecrosis and in the patients with infected pancreonecrosis without retroperitoneal space cellular tissue affection in comparison with patients, suffering infected pancreonecrosis and the retroperitoneal space cellular tissue affection there were more signs, the values ratio or difference of which have deviated from the "Golden section" rule no more than by 5%. While estimating the patients state severity in those, suffering severe forms of AP, using special scales, most precisely the coincidence with a "Golden section" rule was noted, according to scales ASSES and SAPS III. Prognostically unfavorable was a progressive increase of the points sum according to ASSES scale in dynamics of postoperative period.