Rehabilitation of patients with peritonitis during early postoperative period

Early postoperative period is an important and effective part of rehabilitation of patients with peritonitis. The aim of the study was to analyze and improve the methods of rehabilitation during postoperative period, develop rehabilitation measures as relevant and unresolved questions that require further investigation. Materials and methods. 165 patients were examined with acute surgical pathology. 65 patients were examined with diffuse peritonitis, 100 patients with spilled were examined. Patients were divided into two groups: the first group included 75 patients who received general therapy, and the second one contained 90 patients, who got complex rehabilitation. To restore all the functions of organs and systems, exercises were started in 12 -16 hours after the surgery, but their start was individual for each patient. Results. Based on analysis of case histories of patients with peritonitis it was established incomplete all possible use of therapeutic exercises, massage, physiotherapeutic procedures in early postoperative period. Their administration was applied during different periods after surgery and it did not have complex approach. Breathing exercises was performed with an emphasis on diaphragmatic breathing with using techniques with the addition of cough, which differ with dynamic exercises for the upper and lower extremities. The dynamic exercises include bending and straightening the arms at the elbow, abduction hand on shoulder girdle during inspiration and bringing them to the body when exhaling, the chest excursion improved, increasing ventilation and warning stagnation in them. On the second and third day, when pain decreases, patients perform full-breath techniques, and then patients were taught do them themselves. They do 3 -5 deep breaths and this process like inflating rubber balls (breath with constant positive pressure). In the first two days this exercise is conducted from 40 to 60 minutes (during 3 ̶ 5 minutes) it was done mainly due to the pectoral muscles. During the third and fourth sessions exercise therapy was conducted, the patient returned to the sides, and patients received massage from 4 to 6 times. To prevent energy depletion of the body, it was proposed to conduct exercise approximately 3 - 4 times per day, but short sessions lasted 5-7 minutes. It prevents exertion of the body and at the same time it was maintained the required effect of the use of exercise and massage. To prevent complications of respiratory system it was performed inhalation of 5% solution of sea salt that accelerates and facilitates the discharge of phlegm, stimulates the regenerative processes in tissues, improves tissue elasticity. Sea salt has antiseptic, anti-inflammatory and analgesic properties, and it relieves stress and increases vitality. Inhalation of sea salt was carried out twice a day during 5-6 days. Inhaled was carried by ultrasound inhalers-nebulizers. To stimulate peristalsis it was used the technique of electrophoresis with adding bishofite Poltava, using the system "Potok-1". To prevent complications of postoperative wound, ultraviolet radiation, magnetic therapy, laser therapy were used. Conclusions. Integrated and phased approach helped to reduce bronchopulmonary complications in 5.6%, thrombosisin 3.2%, early adhesive intestinal obstruction in 1.1%. Prospects for further investigations. New methods should be carried out and improved in rehabilitation measures during postoperative period.