FIELD: medicine, anesthesiology, resuscitation.
SUBSTANCE: the present innovation deals with treating oncological patients in perioperational period in case of rectal operations accompanied by extensive lymphadenectomy. The method deals with preoperational procedure performed by intravenous injecting by drops crystalloid solution at the volume of 400-800 ml, standard glucoso-potassium mixture at the volume of 500-600 ml, colloid solution 6% or 10% hydrooxyethylated starch or helofusine at the volume of 500-1000 ml, and, also, introduction of aprotinine at the dosage of 180000-220000 IU. Intraoperationally one should intravenously inject by drops a crystalloid solution at the dosage of 8-16 ml/kg/h, colloid solution 6% or 10% hydrooxyethylated starch at the dosage of 4-10 ml/kg/h, then comes crystalloid solution followed by helofusine at the dosage of 4-15 ml/kg/h. Moreover, the volumetric ratio of successively injected crystalloid solution, colloid solution, crystalloid solution and helofusine has been chosen to be equal to 2 : (1-2) :2 : (1-3). Also, intraoperationally, one should introduce aprotinine at the dosage of 80000-120000 IU and cephalosporinic antibiotics at standard dosage in combination with metronidasol. After operation, one should continue the injection of aprotinine every 6 h for 3 d and introduction of antibiotics with metronidasol every 8 h during the first day since the onset of operation and then every 12 h for 2-3 d after operation. In postoperational period it is necessary to carry out early peroral nutritive support by injecting nutrilane and, also, intravenously colloid solution 6% or 10% hydrooxyethylated starch and/or helofusine, aminosteryl KE, glucoso-potassium mixture and crystalloid solutions. The method enables to restore motor-evacuatory function of gastro-intestinal tract at simultaneous decreased manifestation of intestinal deficiency syndrome. It decreases the level of endogenic intoxication during operation and at early postoperational period.
EFFECT: higher efficiency of therapy.
6 cl, 3 ex
