In connection with the expansion of indications for surgical treatment of abdominal diseases and the lack of reliable means of prevention of postoperative adhesive complications remains high. Pressing question of tactics for patients with adhesive disease of peritoneum (SBB) and prehospital.
According to our data the proportion of calls to patients for acute surgical diseases varies from 3,0 to 7,9%, with 22,3% of them to patients before undergoing surgical intervention on the abdominal organs. SBB among this group of patients taking a leading place (59,8%), and adhesive small bowel obstruction (SKN) is 17.2% among all surgical patients.
Most responsible for choosing tactics such patients prehospital is to determine the indications brand viagra for hospitalization. Absolute indications for hospitalization in a surgical hospital, we believe there is any indication of acute disorders of passage of food masses (cramping, delayed stool and gas, bloating, nausea, followed by uncontrollable vomiting), and peritonitis. Is important in the diagnosis of JMC is to test some specific symptoms. Cases of doubt in need of hospitalization, or at least consult a surgeon of such a patient are not rare. On the call is often necessary to differentiate intestinal colic attack and SBB, complicated by the JMC, which is problematic in an ambulance. In this regard, in doubtful cases it is necessary to lean towards hospitalization.
Most patients with PRSP and SKN are moderately severe (41,1%) and satisfactory (29,2%), and do not require special treatment. However, if cramping pain in the prehospital shown the introduction of antispasmodic. SKN often develops in older patients with severe disorders of the respiratory and circulatory system. In these patients electrolyte and metabolic disturbances arising in the JMC, exacerbated over the background of the disease and aggravate a condition that requires its correction has already pre-hospital. In such a situation justified the appointment of cardiac and protivoshokovym funds reolitikov, preparations of potassium. Showing inhalation of humidified oxygen through a mask or endonasal catheter, especially when long distance transport.
Thus, the PRSP and the ANC is a common condition in the practice of emergency medicine that requires a careful differential diagnosis, the correct choice of tactics and treatment of prehospital.
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