Filipovich N E, Kirkovskiĭ V V
Khirurgiia (Mosk). 1990 Jul(7):56-9.
Analysis of the results of treatment of 240 patients with generalized peritonitis of appendicular origin showed that the application of hemosorption led to noticeable and stable diminution of intoxication in 84% of cases. In the ++post-sorption period, the severity of endotoxicosis did not change essentially in 12% of cases and increased in the remaining cases. The therapeutic effect of hemosorption was found to be unstable in patients with signs of multiple organ insufficiency developing in prolonged poorly effective therapy as well as in patients with unrecognized abdominal abscesses, incompetence of the sutures of anastomoses, thrombosis of the mesenteric vessels, and early intestinal obstruction due to adhesions. Endotoxicosis intensified during hemosorption in patients with extensive epifascial phlegmons. It is proved that hemosorption applied repeatedly in the early postoperative period with due account for the individual features of the course of the disease ensures an optimal therapeutic effect.
对240例阑尾源性弥漫性腹膜炎患者的治疗结果分析表明，在84%的病例中，应用血液吸附可使中毒症状明显且稳定减轻。在吸附后阶段，12%的病例内毒素血症的严重程度基本未变，其余病例则有所加重。在长期治疗效果不佳且出现多器官功能不全迹象的患者中，以及在未被识别出腹部脓肿、吻合口缝线不牢固、肠系膜血管血栓形成和因粘连导致早期肠梗阻的患者中，发现血液吸附的治疗效果不稳定。在患有广泛浅筋膜蜂窝织炎的患者中，血液吸附过程中内毒素血症会加剧。事实证明，术后早期根据疾病进程的个体特征反复应用血液吸附可确保获得最佳治疗效果。
