UDK: 616.37-002-06
A. G. Beburishvili, E. N. Zubina, A. S. Popov, M. I. Turovets, Yu. I. Vedenin
Волгоградский медицинский университет, Клиника факультетской хирургии, кафедра анестезиологии и реаниматологии ФУВ, Лаборатория хирургической гепатологии ВМНЦ
To date, the tactics of treatment of patients with pancreatic necrosis has been debated and explored by a number of the leading clinics around the world. One of the unresolved problems is the appropriateness of the thoracic epidural anesthesia. The present cohort study included all patients (n = 493) with clinical pancreatic necrosis, who have presented to the Clinic of Surgery VolgSMU in the period from 1994 to 2013. We proved that the early use of thoracic epidural anesthesia significantly reduced the incidence of foci of infection of pancreatic necrosis and peripancreatic fluid accumulation (from 34,0 % to 11,8 % of the cases (OR 0,26; 95 % CI [0,16—0,42])). Patients of the main group showed a decreased incidence of potentially fatal complications (OR, 0,37; 95 % CI [0,25—0,55]). For example, the use of thoracic epidural anesthesia reduced the risk of ultiple organ dysfunction syndrome (from 14,5% to 4.3% of cases), reduced the incidence of gastrointestinal bleeding (from 12.1% to 8.5% of cases) and the risk of acute myocardial infarction (from 5,3 % to 2,8 % follow-up cases). The mortality rate in the intervention group decreased to 8,1 % of cases, as compared to 22,4 % of the cases in the control group (OR 0,30; 95 % CI [0,17—0,54]). The use of thoracic epidural anesthesia significantly increases the effectiveness of treatment of patients with pancreatic necrosis.
pancreatic necrosis, thoracic epidural anesthesia, a fatal complication.
Туровец Михаил Иванович — к. м. н., ассистент кафедры анестезиологии и реаниматологии ФУВ, Волгоградский государственный медицинский университет, анестезиолог-реаниматолог Клиники №1 ВолгГМУ, email: turovets_aro@mail.ru