COMPARATIVE CHARACTERISTICS OF MECHANISMS OF EMERGENCE OF INTESTINAL FAILURE IN CANCER PATIENTS AFTER MULTI-ORGAN OPERATIONS AND PATIENTS WITH COMBAT INJURY

Resume. Introduction. More and more attention is paid to enteric insufficiency syndrome (IN) in victims of traumatic disease (TC) and after multi-organ surgical interventions, which plays an important role in the initiation and further development of multi-organ dysfunction syndrome (POD) — a systemic process, the mediators of which are endogenous and exogenous circulating factors, the effect of which is not directly related to a severe injury. In victims, with a complicated course of TN and after multi-organ operations in cancer patients, the intestinal tube can be a kind of reservoir of pathogenic bacteria and infections. The reason for this is that bacteria, penetrating through the mucous barrier of the intestinal wall, can ultimately lead to sepsis. Materials and methods. In the course of the clinical study, we examined 57 victims of combat trauma, group 1, and 29 cancer patients, after multi-organ surgical interventions, group 2 of the study. The presence of intestinal insufficiency syndrome in patients was considered the selection criteria. Research results. Studying the pathogenetic mechanisms of enteric insufficiency in groups of patients, we came to the conclusion that it is appropriate to divide them into three main links of pathogenesis: 1 link factors that caused the development of SEN 2 link circulatory disorders 3 links of violation of motor evacuator During ultrasound, the most permanent sign of the intestinal insufficiency syndrome was an increase in the diameter of intestinal loops from 28 to 48 mm found in 79 patients (95.2%). Swelling and thickening of the intestinal wall up to 5 mm were determined in 75 cases (90.4%), the deposition of a significant amount of fluid in the lumen of the small intestine was noted in 76 patients (91.6%), and, depending on the age of the disease, the heterogeneous content ( liquid-gas with uneven pneumatization) in the early stages was replaced by homogeneous hyperechoic with a predominance of liquid. Conclusions. Based on the results of the study, the main mechanisms of the development of enteric insufficiency are: Microcirculation disorders and coagulopathy in 67%. Hypoxemia during multi-organ surgical interventions and multiple combat injuries was diagnosed in 71.2% of cases. Abdominal compartment syndrome in 38% of Systemic inflammatory response syndrome was diagnosed in both groups, in 69% of combat trauma victims and in 34.9% of patients after multi-organ operations.