Novosti
Khirurgii

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Year 2015 Vol. 23 No 1

REVIEWS

A.V. KOCHETKOV, M.S. GUDILOV

CLINICAL AND LABORATORY DIAGNOSIS AND MONITORING OF SEPTIC COMPLICATIONS AFTER ABDOMINAL OPERATIONS

FSBE "All-Russian Center of Emergency and Radiation Medicine named after A.M.Nikiforov of the Russian Ministry of Emergency Situations",
Saint-Petersburg
The Russian Federation

Diagnosis and treatment of patients with advanced pyo-septic complications after abdominal operations remain an urgent problem due to the high mortality rate, especially in the development of abdominal sepsis. In the article the possibilities of current clinical and laboratory methods, including rapid diagnostic tests (RDTs) of sepsis have analyzed; the significance of determination of inflammation markers (interleukin-6, procalcitonin, presepsin), the experience of clinical scales APACHE-II, SOFA and MEDS application for monitoring of the complication, other laboratory methods, including bacteriological diagnosis have evaluated. Early diagnosis and monitoring of the developed complications with the use of current express-methods, according to the authors, permit not only timely to start etiopathogenetical grounded treatment, but also to evaluate its effectiveness for the necessary correction measures.
The primary objective of the treatment is an effective elimination of primary infections focus. Intensive therapy is considered as the priority treatment method: antibacterial, infusion-transfusion, detoxication therapy, correction of systemic disorders of homeostasis, respiratory disorders, nutritional support, and inotropic support (in shock).
According to the analysis of literature the study and application of current methods of clinical and laboratory diagnosis including express-diagnosis has established that the earlier beginning of etiopathogenetical grounded treatment and effective monitoring of the developed complications is considered to be an important direction of improving the treatment outcomes of pyo-septic complications in the abdominal surgery.

Keywords: sepsis, abdominal sepsis, biomarkers of sepsis, diagnosis of sepsis, prognostic scale
p. 105-111 of the original issue
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FGBU "Vserossiyskiy tsentr ekstrennoy i radiatsionnoy meditsinyi
imeni A.M.Nikiforova" MChS Rossii
tel. office: 7-911-003-41-34,
e-mail: spbkaw@yandex.ru,
Kochetkov Aleksandr Vladimirovich
Information about the authors:
Kochetkov A.V. MD, a chief specialist on surgery of FSBE "All-Russian Center of Emergency and Radiation Medicine named after A.M.Nikiforov of the Russian Ministry of Emergency Situations", Saint-Petersburg.
Gudilov M.S. A post-graduate student on surgery FSBE "All-Russian Center of Emergency and Radiation Medicine named after A.M.Nikiforov of the Russian Ministry of Emergency Situations", Saint-Petersburg.
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