Ключевые слова: острый панкреатит, панкреонэкроз, панкреато-кардиальный синдром, синдром ранней реполяризации желудочков, сердечно-сосудистая патология, малоинвазивное вмешательство, открытая лапаротомия.
Korobko l. R. Choice of medical tactic and volume of operative interference for patients with a acute pancreatitis with accompanying cardio-vasculary pathology. Manuscript.
Dissertation on the receipt of graduate degree of candidate of medical sciences after speciality - 14.01.03 surgery. The Vinnytsya national medical university named after M.I. Pirogov M. of Public Health of Ukraine. Vinnytsya, 2008.
In clinical part of work there is information about the choice of medical tactic and volume of operative interference for 103 patients with an acute pancreatitis and accompanying cardio-vasculary pathology. The changes of electric function of myocardium, indexes of retractive ability of myocardium of left ventricle, LPO and AOS, were studied; indexes of hydratation of tissues and endogenous intoxication at the different forms of pancreatitis and at a acute pancreatitis with accompanying cardio-vasculary pathology.
The most informed criteria of early diagnostics and choice of volume treatment of different forms of acute pancreatitis were studied taking including difficulty and prognosis of disease motion on a background cardio-vasculary pathology. The nosotropic ground of conservative intensive therapy and criteria of estimation of its efficiency is given at the different forms of acute pancreatitis in the conditions of accompanying cardiac pathology. A testimony and volume of operative interferences are developed depending on the functional state of the cardio-vasculary system and difficulty and prognosis of motion of acute pancreatitis. It is set that small volume at abdominal laparotomy and littleinvasion method with pressure of carboxyperitoneum 8-11 gg rt. an item is the optimum methods of operative treatment for patients with a destructive pancreatitis and organic diseases of the cardio-vasculary system for diminishing of frequency, difficulty of intra - and after operation cardio - vasculary complications and better after operation rehabilitation of myocardium for such patients.
Keywords: acute pancreatitis, pancreonecrose, cardio-vasculary pathology, laparoscopy a method, abdominal laparotomy.
АОС – антиоксидантна система
ГП –гострий панкреатит
ІС – інтоксикаційний синдром
МДА – малоновий деальдигід
ПЗ – підшлункова залоза
ПОЛ – перекисне окислення ліпідів
СМП – середньо молекулярні пептиди
СПОН – синдром полі органної недостатності
ФК – функціональний клас