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ВОПРОСЫ ПАТОГЕНЕЗА СПАЕЧНОЙ БОЛЕЗНИ БРЮШИНЫ И СОВРЕМЕННЫЕ ПОДХОДЫ К ЕЕ ПРЕДУПРЕЖДЕНИЮ. ОБЗОР ЛИТЕРАТУРЫ

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Аннотация

Послеоперационные спайки по-прежнему представляют собой нерешенную проблему. В настоящее время поиск надежных средств профилак- тики послеоперационного спаечного процесса движется по пути использования разнообразных барьерных противоспаечных средств, поскольку они обладают очевидными преимуществами перед лекарственными средствами. Однако, развитие спаечного процесса обусловлено множеством значимых этиологических и влияющих факторов, и барьерные средства способны лишь уменьшить действие некоторого ряда из них. Другим суще- ственным препятствием в преодолении данной проблемы авторы считают отсутствие единой формальной системы оценки выраженности спаечной болезни брюшины, так как существующие индивидуальные оценочные подходы не позволяют сравнивать параметры эффективности между тем или иным способом предотвращения спаечного процесса. В представленном обзоре детально рассмотрены достоинства и недостатки некоторых используемых в практике барьерных средств. По мнению авторов, основа успешного решения проблемы спаек состоит в сочетании качественной хирургической техники вмешательства с методами предупреждения скрытых повреждений брюшины и интраоперационной инстилляцией поли- компонентного противоспаечного барьерного геля, выбор которого основан на доказанной в строгих клинических испытаниях эффективности.

Об авторах

О. Э. Луцевич
ГБОУ ВПО Московский государственный медико-стоматологический университет имени А.И. Евдокимова
Россия


В. П. Акимов
Северо-Западный государственный медицинский университет имени И.И.Мечникова
Россия


В. Г. Ширинский
ГБОУ ВПО Московский государственный медико-стоматологический университет имени А.И. Евдокимова
Россия


А. А. Бичев
ГБОУ ВПО Московский государственный медико-стоматологический университет имени А.И. Евдокимова
Россия


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Луцевич О.Э., Акимов В.П., Ширинский В.Г., Бичев А.А. ВОПРОСЫ ПАТОГЕНЕЗА СПАЕЧНОЙ БОЛЕЗНИ БРЮШИНЫ И СОВРЕМЕННЫЕ ПОДХОДЫ К ЕЕ ПРЕДУПРЕЖДЕНИЮ. ОБЗОР ЛИТЕРАТУРЫ. Московский хирургический журнал. 2017;(3):11-26.

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