REHABILITATION OF PATIENTS WITH PERITONITIS IN EARLY POSTOPERA-TIVE PERIOD

In the early postoperative period is an important and effective timely initiation of rehabilitation. The aim of our study was to analyze and improve the methods of rehabilitation in the postoperative period, develop a set of rehabilitation measures like relevant and unresolved question that requires further investigation. We examined 165 patients with acute surgical pathology. With diffuse peritonitis was 65 patients, with spilled 100 patients. Patients were divided into two groups identical in age and severity of disease. The first group - 75 patients receiving standard therapy, and the second group - 90 patients, which additionally carried out the complex rehabilitation. In order to quickly restore all the functions of organs and systems, exercises started in 12 -16 hours after surgery, but their start was individualized for each patient. Patients performed breathing exercises, combining exercise, massage, physiotherapy for the prevention of bronchopulmonary, hypodynamic, thromboembolic complications, and complications the postoperative wound. Breathing exercises performed with an emphasis on diaphragmatic breathing using techniques with the addition of cough, which alternating 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 is decreasing, patients perform a full-breath techniques, and then we teach the patient do it alone. 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 are conducted every 40 to 60 minutes during 3 ̶ 5 minutes. mainly due to the pectoral muscles. At 3-4 day sessions conducted exercise therapy, the patient returned to the sides, held 4 to 6 times ̶ massage. To prevent energy depletion of the body, we proposed to conduct exercise 3 - 4 times a day, but short sessions of 5 - 7 minutes. It prevents overload of the body and at the same time maintain the required tonic effect of the use of exercise and massage. To prevent complications of respiratory system we perform inhalation 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 adding sea salt carried out twice a day for 5 - 6 days. Inhaled carried ultrasound inhalers - nebulizers. To stimulate peristalsis we use the technique of electrophoresis with adding bishofite Poltava, using the system "Potok-1". For preventing complications postoperative wound, apply ultraviolet radiation, magnetic therapy, laser therapy. Integrated and phased approach helped reduce bronchopulmonary complications in 5.6%, thrombosisin 3.2%, early adhesive intestinal obstruction in 1.1%.