OPTIMIZATION OF SURGICAL TACTICS FOR PERFORATED DUODENAL ULCER
Keywords:
Peptic ulcer of the duodenum, ulcer perforation, nature of the microflora, pH value, surgical tacticsAbstract
To improve the results of surgical treatment of patients with perforated duodenal ulcer by optimising the choice of the operation volume based on predicting the severity of peritonitis course.
Material and methods: 234 admitted patients with duodenal ulcer complicated by perforation, treated in Samarkand branch of RSCEMС in the period from 2017 to 2022, were included in the study. The inclusion criteria for the study were: the presence of duodenal ulcer disease complicated by perforation and widespread peritonitis in the patient; the duration from the moment of perforation was more than 6 hours.
Results: Thus, there was a statistically significant increase in the number of pathogenetically justified primary surgical procedures in the patients of the main group by 18.2% compared to the patients of the control group. Pearson's X was 26.84 (p < 0.001). The increase in absolute benefit (ABP) was 18.2%. The increase in relative benefit (ROB) was 30.8%.
Conclusions: A pattern of changes in the nature of the microflora of the abdominal cavity with its pH values was established. With a pH value of the exudate of the abdominal cavity of 6.4 or less, bacillary microflora was detected in 100% of patients, while depending on the timing of perforation up to 24 hours in 19.4%, over 24 hours - 54.2.
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