Экстренные состояния интенсивной терапии при острых кишечных инфекциях у детей

Аннотация

Ключевые слова: Несмотря на успехи, достигнутые в борьбе со многими диарея, инфекционными заболеваниями, проблема диареи в инфекционные Узбекистане, как и во всем мире, остается актуальным. заболевания, Медико-социальная значимость проблемы определяется не острые кишечные инфекции, только значительной распространенностью заболевания, регидратация. но и высокой распространенностью инфекционных заболеваний. Выявляются тяжелые сложные формы заболевания, особенно у детей раннего возраста. Кроме того, диарейные заболевания косвенно способствуют возникновению других инфекций, так как приводят к истощению и, как следствие, снижению сопротивляемости организма. Несмотря на наличие данных из литературы по изучению и лечению диареи, острых клинических инфекций, особенно у детей раннего возраста, многие клинические и организационные аспекты остаются нерешенными. При острой кишечной инфекции (ОКИ) неотложное лечение часто сводится к устранению высыхания различной степени с помощью пероральной и внутривенной регидратации. 163 Жамият ва инновациялар – Общество и инновации – Society and innovations Special Issue – 6 (2021) / ISSN 2181-1415 GOAL He will study the pathological conditions that occur with acute intestinal infec- tions and other pathological conditions that require intensive therapeutic measures. Research material and methods An analysis of 350 patients who were treated in the intensive care unit for acute respiratory infections for 5 years (2005–2010). Patients treated in the intensive care unit amounted to 12.5 %, of all children with acute respiratory infections admitted to the hospital, most of them (89 %) were infants. Determining the indications for hospitalization in the intensive care unit, the following emergency conditions were distinguished in children with acute intestinal infections and, accordingly, differentiated therapeutic measures were carried out. 1. Intestinal toxicosis with exsiccosis II-III degree. This condition is common, in 42 % of cases, usually with acute respiratory infections, accompanied by watery diarrhea and repeated vomiting, that is, with escherichiosis, foodborne toxic infections. However, in infants, it can develop with a severe form of acute intestinal in – fections of any etiology. The main link in the disorders should be considered exico – sis with a loss of 5 to 15 % fluid with the development of hypokalemia and hypopro- teinemia. The latter are often detected after correction of exsiccosis and elimination of hemoconcentration. In patients up to a year of age, exicosis is mainly isotonic, a decrease in sodium is rare. Disturbances from the central nervous system, micro circulation and acid-base state are secondary. The basis of therapy in this condition is timely and adequate correction of water-electrolyte balance and hypoproteinemia with the help of infusion therapy, both on the first day of the patient’s admission and for the entire period of continuing losses. To assess the adequacy of the treat- ment, a constant clinic laboratory monitoring is necessary. Informative laboratory indicators are the level of hematocrit and the concentration of electrolytes in plas- ma, primarily K + and Na +, as well as the level of total protein. As infusion agents, we used an isosmotic glucose-polyionic solution (contains 86 mmol / I sodium). Of the colloidal solutions in the acute phase, reopoliglukin is most suitable. Albumin so- lutions were used after dehydration was eliminated; their use as a starting solution is undesirable. The volume of infusion therapy depends on a number of factors: the age of the child. the degree of exicosis, the volume of ongoing losses with stool and vomiting, digestion, write and drink, etc. But the preparation of corrective programs and the use of standard solutions allows the doctor to quickly make the necessary calculations. Cocarboxylase, ATP, and drugs to improve microcirculation (trental, curangil) are also added to the infusion media. More than half of the children in this group can be treated without antibiotics, or receive them only by mouth. 2. Generalized forms of intestinal infections, septicemia, occurring with severe intoxication phenomena. Patients with these forms accounted for 33 % of all pa- tients in the intensive care unit, these conditions are most often observed with sal- monellosis, yersiniosis, and klebsiellosis. They are characterized by the presence of two or more lesions, of which pneumonia and acute otitis media are most common, pyelonephritis is rare and rarely – myocardit is. The severity of the condition of patients is explained mainly by bacterial intoxication; lethargy, refusal to eat and drink, fever, infrequent vomiting, enlargement of the liver and spleen, and intestinal paresis are noted. Sub compensated metabolic acidosis, hypokalemia, hypoproteinemia, changes in the blood formula, leukocyte index increased within 3-8units, intoxication are de- tected in the laboratory. For patients of this group, a quick etiological