COMPLEX DIAGNOSTICS AND ACUTE PERITONITIS PROGNOSIS

Despite new advanced kinds of treatment, the consequences of acute peritonitis (AP) management are not always satisfactory due to the unimproved management of disease, lack of reliable scales of prediction and complications. Aim of the study. To develop an improved method for evaluating the peritonitis prevalence and prognosis. Materials and methods. The research has been carried out on 20 albino non-pedigree rats. AP has been modelled by intraperitoneal injection of 20% fecal matter in 10 animals, in others – by sterile bile. Before modelling, in 6 and 12 hours after the AP inducement the width of scattering zone of laser beam (WSZLB) was found out. The scattering zone was found out on different quadrants of parietal peritoneum. Medical records of 169 patients (aged 17 – 84) with acute surgical pathology (complicated by various forms of peritonitis) of the abdominal cavity organs have been analyzed. The following data was processed: having postoperative complications, clinical and anthropometric data, results of laboratory methods, parameters of Mannheim peritonitis index, comorbid pathology class, and age. Influence factors were determined with the help of dispersion analysis. Results of the study. WSZLB is to be increased dur-ing aseptic peritonitis, comparing to intact cavity, in 1, 5 – 2 times, and during septic peritonitis the measurements of scattering zone increase twice as much. The scale has been developed according to which the complications prediction is performed in two stages. Groups risk separation is performed as following: less than 18 points – usual, 18-25 points – increased (mainly wound complications), 26-34 points – average (abscesses, infiltrates, diffuse peritonitis, failure of sutures), more than 35 points – high risk (severe peritonitis, sepsis). Conclusions: 1. The scale has been developed for predicting the risk of postoperative complications. According to the scale, the evaluation is performed in two stages – before and during opera-tion, which allows highlighting groups of low, average and increased risk of postoperative complications, and allows taking preventive measures during pre-operative preparation, suboperatively and during postoperative treatment. 2. For objective evaluation of peritonitis prevalence a method which is based on detecting the ratio between both the width of laser beam scattering zone of affected and intact cavity is used, which also increases during aseptic peritonitis in 1,5 – 2 times, and during septic peritonitis twice as much.