APPLICATION OF RESONANT STIMULATION IN PATIENTS WITH OF SECONDARY PERITONITIS FOR PREVENTION OF THE INTESTINAL PARESIS IN THE POSTOPERATIVE PERIOD

Objective: a pilot project for the comprehensive correction of motor-evacuation disorders in the postoperative period in patients with common forms of secondary peritonitis using transcutaneous resonant electrostimulation. Materials and methods: The treatment outcomes of 125 patients with common forms of secondary peritonitis for the period 2015-2018 have been analyzed. Gender distribution with a predominance of the male sex (2.7: 1), the average age is 35.5 ± 2.02 years. The 2nd study groups were formed based on blind distribution: group 1 (n-67; management of the postoperative period using resonance stimulation in complex treatment) and group 2 (n-58; postoperative management of patients strictly according to regulatory documentation). The groups were fully representative by sex, age, volume of operation, as well as the initial severity of the condition according to APACHe II (p≥0.05). Pre-operatively and in the postoperative period, on the 1st, 3rd, 5th and 7th days,intra-abdominal pressure manometry (IAP) was performed transvesically according to the generally accepted method. All patients were monitored for peristaltic activity on the “selective gastrointestinal polygraph” on the 1st, 3rd, 5th and 7th, in group 1 the following ReS was performed (patents of the Russian Federation 2648819 and 2655788).Results: In the postoperative period, the initial peristaltic activity had low oscillation values. Against the background of resonance stimulation in group 1, a faster recovery period of the motor-evacuation function of the intestine was noted, an increase in oscillations in all departments, which differed qualitatively and quantitatively from the identical parameters of group 2 (p≤0.05). By the 5th day of treatment, the complete recovery of the motor-evacuation function of the digestive tract was observed: in group 1 in 63 (96.9%), in group 2 in 48 patients (82.7%; p≤0.05). There was a significant dissociation of IHD in favor of the 1st group: on the 3rd, 5th and 7th day of treatment (p≤0.05). The analysis of “large” complications revealed in total in 10 patients (17.2%) the need to perform re-operations in group 2 (p≤0.05): 6 cases of perforations of acute ulcers of the small intestine, 4 cases of dynamic ileus, resistant to therapy. In group 1, a laparotomy was performed in 1 patient. The duration of inpatient treatment in group 2 was significantly higher (10.3 ± 0.8 days) than in group 1 (7.4 ± 0.7 days; p≤0.05). Conclusion: Based on the data obtained, the introduction of resonant electrostimulation for the prevention of motor-evacuation disorders in the postoperative period in patients with common forms of secondary peritonitis helps accelerate the recovery of intestinal motility, normalize the physiological passage of chyme, reduce IAP and thus minimize the risk of multiple organ failure.

diffuse peritonitis, postoperative intestinal paresis, resonant electrostimulation