Incidence and the risk factors of the postoperative stress ulcers in children
Objective. Аnalysis of correlational link between incidence of postoperative stress-induced changes (SIC), іntraoperative dynamics of peripheral blood flow, called NIRS, degree of the gastric content acidity and the operative intervention traumaticity.
Маterials and methods. There were conducted fibroesophagogastroduodenoscopy with pH-metry preoperatively and in early postoperative period, іntraoperative monitoring of gastric content acidity and registration of dynamics of the peripheral blood flow, as well as calculation of coefficient of the operation traumaticity degree (CTD) in accordance to method of V. P. Polyovyi.
Results. SIC were revealed in 25 (33.3%) of 75 patients observed. The index of the gastric content pН in patients with the SIC signs in postoperative period have constituted 2.05 ± 0.23 at average, while in patients without postoperative complications in the gut mucosa – 3.42 ± 0.97; the NIRS index – accordingly, 63.13 ± 1.39 and 67.80 ± 1.97; CTD – accordingly, 19.4 ± 3.58 and 4.45 ± 2.0.
Conclusion. The SIC incidence in postoperative period in children constitutes 33.3%, what explains actuality of the investigation trend selected. The acidity state of gastric content, as well as combination of significant degree of the operation trauma severity with massive blood loss, characterizing certain indices of CIS and NIRS, constitute important etiological factors for the stress ulcers and erosions incidence.
2. Kulakova E. Posleoperacionnie ostrie eroziy i jazvy – ih klinico-biohimicheskiy prognoz. toperative acute erosions and ulcers and their clinical and biochemical prognosis. PhD [dissertation]. Saratov; 2004. 141 s. [In Russian].
3. Eckardt AJ, Jenssen C. Current endoscopic ultrasound-guided approach to incidental subepithelial lesions: Optimal or optional? Ann Gastroenterol. 2015 Apr-Jun;28(2):160–72. PMID: 25830949.
4. Starkov JuG, Solodinina EN, Novozhilova AV. Podslizistye novoobrazovanija zheludochno-kishechnogo trakta v jendoskopicheskoj praktike. Hirurgija. Zhurnal im. N. I. Pirogova. 2010;(2):51–9. [In Russian].
5. Rosch T, Kapfer B, Will U, Baronius W, Strobel M, Lorenz R, Ulm K. Accuracy of endoscopic ultrasonography in upper gastrointestinal submucosal lesions: a prospective multicenter study. Scand J Gastroenterol. 2002Jule;37(7):856–62. http://doi.org/10.1080/gas.37.7.856.862.
6. Barbour RL, Graber H, Lubowsky J, Anderson R. Monte Carlo modeling of photon transport in tissue. Biophys J. 1990 Feb;57(2):381a-382a.
7. Shaharin A. Photon time-of-flight and continuous-wave near-infrared-spectroscopy of human skeletal muscle tissue; a comparative study [master’s thesis]. Sweden: Lund University; 2013. 44 p.
8. Poloviy VP, Sidorchuk RI, Voznyuk SM, Palyanytsia AS. Evaluation and prediction of the degree of severity of early postoperative period in patients with acute surgical diseases of the abdominal cavity, complicated by peritonitis. Ukrainian Journal of Surgery. 2013; (2): 80-4. [In Ukrainian].
Copyright (c) 2019 Liga-Inform
This work is licensed under a Creative Commons Attribution 4.0 International License.