BARRIER PROPHYLAXIS OF ADHESIVE INTESTI-NAL OBSTRUCTION

Introduction. Adhesive abdomen disease is a defensive reaction of an organism against injuries or irritations accompanied with local or generalized adhesions development as the result of surgical invasion, trauma or inflammatory diseases of abdomen cavity organs. However, in 36-60% cases, adhesive abdomen disease declares itself clinically by intestinal dysfunction with presence of chronical abdomen pain and in a number of cases, it can be complicated with the development of acute adhesive small intestinal obstruction. Aim of the research. To develop a method of barrier prophylaxis of adhesive abdomen disease and acute adhesive small intestinal obstruction. The results of the research. As the result of an exper-imental study, it was established that on the 3rd day after the elimination of acute adhesive small intestinal obstruction, the animals of the first sub-group appeared to have the expansion of the small intestine with moderate number of adhesions on au-topsy. From 7th to 28th day - the enlargement of the small intes-tine was not marked, but a pronounced adhesion process was present. Morphological investigation revealed an increase in the degree of severity of alterative, inflammatory and vascular changes in the wall of the small intestine from 3 till 28 day of the experiment, and in the mesenteriolum it revealed inflammatory and vascular changes, activation of the adhesion development process. The animals of the second sub-group who were given polyethylene glycol 4000 to prevent adhesive abdomen disease did not have enlargement of the small intestine and adhesions process was absent starting from the 7th day of the experiment till the 28th day. According to the pathomorphological study data, it was found that the use of polyethylene glycol leads to a decrease of alterative, inflammatory and vascular changes in the wall of the small intestine and its mesenteriolum. As the result of clinical study, it was established that according to anamnesis data, in all 100% of cases, patients had one or more surgical interventions in the past. The use of observational X-ray was informative in 47 (78.3%) cases. In 36 (60%) cases an additional Schwarz test was performed. An ultrasound study was conducted for 40 (66.6%) patients. A positive effect of conservative therapy was observed in 19 (31.7%) cases. 41 (68.3%) patients underwent a surgery. 21 (51,2%) patients with surgeries had the prophylaxis of adhesive abdomen disease and acute adhesive small intestinal obstruction with polyethylene glycol. The disussion of the results. The treatment tactic of acute adhesive small intestinal obstruction should begin with conservative treatment and only with its ineffectiveness, according to clinical, radiological and ultrasound data, surgical part should be performed. The data obtained from our experimental study indicate that the use of Dekasan solution after the elimination of acute adhesive small intestinal obstruction is not an optimal way to solve the problem of adhesive abdomen disease and acute adhesive small intestinal obstruction. Conclusions. The developed prevention method against adhesive abdomen disease and acute adhesive small intestinal obstruction using the hypotonic solution of polyethylene glycol 4000 allows to perform reliable prophylaxis of the abdominal adhesions formation starting from the first day of the postoperative period.