Interest in the problem of adhesive intestinal obstruction is caused by the increasing frequency of presence of this disease among surgical patients. In the structure of emergency surgical pathology intestinal obstruction has a low specific gravity (about 4%), while adhesion obstruction prevails, for up to 80% of the total number of cases. Substantial attention in the literature is paid to surgical methods of treatment, postoperative tactics are often missed. At the same time recommendations for doctors are contradictory. Liberal approaches to patient management give rise to a lack of awareness of the continuity of the actions of the resuscitator and the operating surgeon, indications for prescribing drugs and consistency in the providing medical care. The following strategy is elaborated: intestinal intubation is used for the purpose of prolonged decompression and enterosorption, and if there are contra-indications to nasogastrointestinal intubation, it is needed to drainage through an enterostomy or cecostomy; to replenishment of nutritional deficiencies with the help of enteral tube feeding, which promotes reducing the number of infectious and metabolic disorders; to stimulate of intestinal motility through catheterization of the epidural space and to inject lidocaine or another anesthetic in order to activate its neuromuscular apparatus and to increase the tone of parasympathetic innervation.

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Автор(ы): D. A. Klyuyko, V. E. Korik, S. A. Zhidkov