hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2016441-46hepato-75Research ArticleПОДЖЕЛУДОЧНАЯ ЖЕЛЕЗАPANCREASВнутрибрюшная гипертензия и панкреатогенный перитонитIntraabdominal Hypertension and Pancreatogenic PeritonitisЗубрицкийВ. Ф.ZubritskiyV. F.

Doct. of Med. Sci., Professor, Chief Surgeon of Ministry of Internal Affairs of Russia, Head of the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at the Moscow State University of Food Production; Honorary Doctor of Chechen Republic, Honorary Doctor of the Russian Federation, Colonel of Internal Service

Doct. of Med. Sci., Professor, Chief Surgeon of Ministry of Internal Affairs of Russia, Head of the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at the Moscow State University of Food Production; Honorary Doctor of Chechen Republic, Honorary Doctor of the Russian Federation, Colonel of Internal Service

zubvlad2009@yandex.ruЗабелинМ. В.ZabelinM. V.

Doct. of Med. Sci., Professor of the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at the Moscow State University ofFood Production

Doct. of Med. Sci., Professor of the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at the Moscow State University ofFood Production

КолтовичА. П.KoltovichA. P.

Doct. of Med. Sci, Chief Surgeon at the Main Clinical Hospital of the Ministry of Internal Affairs of Russia, Professor of the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at Moscow State University of FoodProduction, Colonel of Internal Service

Doct. of Med. Sci, Chief Surgeon at the Main Clinical Hospital of the Ministryof Internal Affairs of Russia, Professor of the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at Moscow State University of FoodProduction, Colonel of Internal Service

ЛевчукА. Л.LevchukA. L.

Doct. of Med. Sci., Professor of the Department of Surgery with the Course of Traumatology and Orthopedy at the Institute of Postgraduate Education, Pirogov National Medical Surgical Center

Doct. of Med. Sci., Professor of the Department of Surgery with the Course of Traumatology and Orthopedy at the Institute of Postgraduate Education, Pirogov National Medical Surgical Center

АйрапетянА. Т.AirapetyanA. T.

Cand. of Med. Sci., Professor at the Department of Surgery with the Courses ofAnesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at Moscow State University of Food Production.

Cand. of Med. Sci., Professor at the Department of Surgery with the Courses ofAnesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Institute of Medical and Social Technologies at Moscow State University of Food Production.

ГолубевИ. В.GolubevI. V.

Postgraduate Student of the Department of Surgical Infections, Pirogov National Medical Surgical Center

Postgraduate Student of the Department of Surgical Infections, Pirogov National Medical Surgical Center

РозбергЕ. П.RozbergE. P.

Doct. of Med. Sci., Professor at the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy.Moscow State University of Food Production

Doct. of Med. Sci., Professor at the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy.Moscow State University of Food Production

КореневД. Н.KorenevD. N.

Teacher at the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Moscow State University of Food Production

Teacher at the Department of Surgery with the Courses of Anesthesiology and Reanimatology, Neurosurgery, Traumatology and Orthopedy. Moscow State University of Food Production

Институт медико-социальных технологий Московского государственного университета пищевых производствРоссияInstitute of Medical and Social Technologies at Moscow State University of Food ProductionRussian FederationНациональный медико-хирургический центр им. Н.Н. ПироговаРоссияPirogov National Medical and Surgical CenterRussian Federation2016241220172144146Copyright © Зубрицкий В.Ф., Забелин М.В., Колтович А.П., Левчук А.Л., Айрапетян А.Т., Голубев И.В., Розберг Е.П., Коренев Д.Н., 20172017Зубрицкий В.Ф., Забелин М.В., Колтович А.П., Левчук А.Л., Айрапетян А.Т., Голубев И.В., Розберг Е.П., Коренев Д.Н.Zubritskiy V.F., Zabelin M.V., Koltovich A.P., Levchuk A.L., Airapetyan A.T., Golubev I.V., Rozberg E.P., Korenev D.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/75

Цель: определение прогностической ценности мониторинга внутрибрюшного давления при лечении больных панкреонекрозом в асептическую и инфекционную фазу.Материал и методы. Представлены результаты измерения и динамики внутрибрюшного давления у 78 больных панкреатогенным перитонитом.Результаты. Установлено, что панкреатогенный перитонит в 97,8% наблюдений осложняется повышением внутрибрюшного давления и развитием внутрибрюшной гипертензии. Выявлена корреляционная зависимость между величиной внутрибрюшного давления и распространенностью воспалительного процесса в брюш ной полости и забрюшинной клетчатке (p < 0,05), а также между уровнем внутрибрюшного давления и степенью тяжести состояния по шкале APACHE II (p < 0,05).Заключение. Продолжительное сохранение внутрибрюшной гипертензии у больных панкреатогенным перитонитом способствует прогрессированию полиорганной недостаточности и требует выполнения лапаротомии, одной из задач которой является уменьшение внутрибрюшного давления за счет санации брюшной полости и забрюшинной клетчатки.

Aim. To define the prognostic value of intra-abdominal pressure monitoring in the treatment of patients with pancreatic necrosis in aseptic and infectious phases.Material and Methods. The article shows the results of measurements and dynamics of intra-abdominal pressure in 78 patients with pancreatogenic peritonitis.Results. It was established that pancreatogenic peritonitis was complicated by increased intra-abdominal pressure and the development of intra-abdominal hypertension in 97.8%. A correlation between IAP and severity of abdominal and retroperitoneal inflammation (p < 0.05), as well as between IAP and APACHE II score was determined (p < 0.05).Conclusion. Prolonged abdominal hypertension promotes the development of multiple organ failure and requires a laparotomy in order to reduce the intra-abdominal pressure via abdominal and retroperitoneal spaces sanitation

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The authors declare that there are no conflicts of interest present.