METHOD FOR INTRAOPERATIVE PROPHYLACTIC TREATMENT OF ISCHEMIC DAMAGE TO PANCREAS AND LIVER IN CASE OF COMBINED SHOCK-PRODUCING INJURY

FIELD: medicine.SUBSTANCE: method of cannulation of the splenic artery and splenic vein is used after the performed splenectomy to perform regional intra-arterial and intravenous perfusion therapy. Solutions are injected at a volumetric rate that allows the fastest possible normalisation of the systemic blood pressure, which should not be less than 70 mm Hg. At that, up to 60% of the infusion volume is injected through the arterial access, and intraarterial infusion includes perfluorane - 400.0 ml, 0.25% novocaine solution 100.0, 0.9% NaCl solution 400.0 and Contrykal 300 thous. units, Ringer's solution 500.0 and mexidol 300 mg, 0.9% NaCl solution 400.0 and 5-fluorouracil 500 mg; perfluorane 400.0 ml, reopolyglucin 400 ml, gelafusin 500 ml are injected simultaneously intravenously. Infusion is performed in a thermostated version at 37ºC at the background of local hypothermia of the pancreatobiliary zone. In a situation requiring application of the technique of stepwise "damage control" interventions, catheters for intra-arterial and intravenous infusion are withdrawn to the anterior abdominal wall, continuing the regional anti-shock therapy as part of the anti-shock therapy complex. A laparostome is applied. On day 2-3, programmed relaparotomy is performed. The final amount of intervention is performed on the abdominal organs, vessels catheterization is eliminated, arterial and venous accesses are ligated.EFFECT: method allows to reduce the frequency of acute traumatic pancreatitis and acute hepatic insufficiency in case of combined shock-producing injury, to increase the survival rate of patients of young and middle working age with severe shock-associated injuries, to exclude severe stage complications of traumatic disease, to reduce lethality in this category of victims.2 cl, 2 ex, 3 dwg Изобретение относится к медицине, а именно к хирургии сочетанных повреждений. Методом канюлирования селезеночной артерии и селезеночной вены после осуществленной спленэктомии проводят регионарную внутриартериальную и внутривенную перфузионную терапию. Растворы вводят с такой объемной скоростью, которая позволяет добиться максимально быстрой нормализации системного артериального давления, которое не должно быть менее 70 мм рт. ст.. При этом до 60% инфузионного объема вводят через артериальный доступ, и внутриартериальная инфузия включает перфторан - 400,0 мл, раствор новокаина 0,25% 100,0, раствор NaCl 0,9% 400,0 и контрикал 300 тыс. ЕД, раствор Рингера 500,0 и мексидол