EVALUATION OF HEMODYNAMIC CHANGES IN PATIENTS WITH URGENT SURGICAL PATHOLOGY IN MILITARY MEDICINE

Аннотация

INTRODUCTION Acute diseases of the abdominal organs are often Perioperative cardiac hemodynamic disturbances accompanied by the development of severe and acute coronary events (ACS) are serious complications, including multiple organ failure, the complications in patients with emergency cause of which in 97% of cases is intra-abdominal abdominal surgery and trauma, especially in the hypertension (IAH) (1,4,3,9). setting of IAH. Timely diagnosis of such disorders plays an important role in preventing serious The problem of IAH has attracted the interest of consequences. One of the main tools for early surgeons, who have identified a relationship diagnosis of cardiovascular disorders is a non- between the tension of the anterior abdominal wall invasive study - echocardiography (EchoCG), and the degree of respiratory failure (2,5,7). Many which allows you to assess the functional and studies have been conducted on the negative effect structural changes in the heart, as well as identify of IAH on central and intracardiac hemodynamics. signs of myocardial ischemia at early stages. It was obvious that an increase in IAH leads to an increase in patient mortality [6,8,10]. Aim of the study. To study hemodynamic changes in patients with urgent surgical pathology in https://www.theamericanjournals.com/index.php/tajmspr 23 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE11 military medicine depending on the presence of the study was conducted between military and intra-abdominal hypertension civilians with acute surgical abdominal pathology depending on the presence of intra-abdominal Research material. A comparison of the results of hypertension. Table 1. Distribution of patients into groups and subgroups bygroup A subgroup, In the subgroup total patients with IAH patients without IAH groups n % n % n % MG - main group, patients are military 39 34,8% 73 65,2% 112 48,3% personnel CG comparison group, civilian 49 40,8% 71 59,2% 120 51,7% patients Note: IAH intra-abdominal hypertension echocardiographic examination, ultrasound of A study was conducted on 232 patients with abdominal organs, measurement of intra- emergency surgical diseases and abdominal abdominal pressure with a Faley catheter injuries who were treated at the intensive care unit according to the S.E. Bradley and G.P. Bradley of the Republican Scientific Center for Emergency method, statistical processing of results. Medical Care of the Ministry of Health of the Republic of Uzbekistan and at the Military Hospital RESULTS of the Ministry of Health of the Republic of The conducted study of hemodynamic parameters Uzbekistan in the period from 2021 to 2024. The in patients of both subgroups with IAP+ and IAP - main group (MG) consisted of 112 military patients demonstrated significant differences between (48.3%), in this group subgroup A consisted of 39 groups and subgroups. patients (34.8%) with intra-abdominal Table 2 presents the results of a comparative hypertension (IAH+), subgroup B - 73 (65.2%) analysis of hemodynamic parameters in patients without intra-abdominal hypertension (IAH-) with elevated and normal intra-abdominal (Table 1). The comparison group (CG) consisted of pressure (IAP) in two groups: civilian patients and 120 civilian patients (51.7%). Subgroup A CG military personnel. consisted of patients with IAH 49 patients (40.8% of the number of CG patients), subgroup B-CG - In the subgroup A CG, the heart rate was 95.2 ± consisted of 71 patients (59.2%) (Table 1). 10.3 bpm, which was significantly higher than in the subgroup B-CG - 78.4 ± 6.5 bpm. Similarly, in METHODS the comparison group among military personnel, Blood pressure monitoring, ECG monitoring, the subgroup A-MG had a rate of 88.7 ± 8.2 bpm, https://www.theamericanjournals.com/index.php/tajmspr 24 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE11 while the subgroup B-MG had 75.6 ± 5.4 bpm. All results were also statistically significant (p < these differences were statistically significant with 0.001). The diastolic pressure in the A-CG a p-value < 0.001. In the A-CG subgroup, systolic subgroup was 95.1 ± 8.4 mm Hg versus 85.2 ± 6.8 blood pressure was 150.3 ± 12.5 mmHg, which mm Hg in the B subgroup. In the A-MG subgroup, significantly exceeded 130.1 ± 9.6 mmHg in the DBP was 90.5 ± 7.5 mm Hg, while in the B-MG patients in the B-MG subgroup. In the A-MG subgroup it was 80.3 ± 5.9 mm Hg. These subgroup, SBP was 140.6 ± 10.8 mmHg compared differences are also statistically significant (p < with 125.4 ± 7.3 mmHg in the B-MG subgroup. All 0.001) (Table 2). Table 2. Comparative analysis of hemodynamic parameters Subgroup Subgroup A Subgroup В Subgroup А Parameter В CG MG (n=39) MG (n=73) CG (n=49) (n=71) Heart rate (bpm) 88.7 ± 8.2 75.6 ± 5.4 95.2 ± 10.3 78.4 ± 6.5 Systolic blood pressure 140.6 ± 10.8 125.4 ± 7.3 150.3 ± 12.5 130.1 ± 9.6 (mmHg