Опубликовать статью

Информационное партнерство

Инфоресурсы

Контакты

«

Vol. 21, Art. 80 (pp. 1025-1037)    |    2020       

»

State of emergency surgical care in saint petersburg for acute abdominal diseases

Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine, Saint Petersburg, Budapeshtskaya str., 3
S.M. Kirov Military Medical Academy, Saint Petersburg, Akademika Lebedeva str., 6

Brief summary

The main trends in emergency surgical care of Saint Petersburg for acute diseases of the abdominal organs in the period 2017-2019 are presented. A comparative analysis of indicators was carried out, covering 15 city hospitals (excluding Federal and Departmental) in Saint Petersburg, where more than 90 % of emergency surgical interventions are performed for acute diseases of the abdominal cavity in adults with a number of nosological forms, united by the general concept of «sharp stomach» : acute appendicitis, acute cholecystitis, acute pancreatitis, perforated gastric and duodenal ulcers, acute gastroduodenal bleeding, strangulated hernias and acute intestinal obstruction. For the analyzed period, the number of operations remained at the level of 10,6-11 thousand per year. The increase was noted due to an increase in operational activity, which in 2019 amounted to 71,84 %. The incidence of acute appendicitis increased from 29,44 % to 34,06 %. The incidence rate of acute cholecystitis and acute pancreatitis did not change significantly during 2017-2019. On the 4th place in the frequency of occurrence remain acute gastroduodenal bleeding - 9,01 %. The number of patients with acute intestinal obstruction decreased to 6,79 % and strangulated hernias to 3,68 %. The proportion of patients with perforated gastric and duodenal ulcers over 3 years remained almost unchanged at 4,14 % in 2019. Postoperative mortality in 2018 and 2019 decreased to 3,28 % and 2,91 %, respectively. The highest mortality rates were observed in patients with acute pancreatitis, perforated gastric and duodenal ulcers, acute gastroduodenal bleeding and acute intestinal obstruction. About half of the total number of patients (47,84 %) with acute surgical pathology were hospitalized later than 24 hours from the onset of the first symptoms of the disease, while the rate in 2017 was 51,52 %, in 2018 - 51,36 %. Leading positions in terms of hospitalization after 24 hours are occupied by: acute intestinal obstruction, acute cholecystitis, acute pancreatitis and acute gastroduodenal bleeding. In 2019, there is an increase in the share of operations performed up to 6 hours (62,29 %) compared with 2017 (60,55 %) and 2018 (57,98 %).


Key words

emergency surgical care, abdominal surgery, «sharp stomach», surgery activity, mortality.

Reference list

1. Revishvili A.Sh. Sostoyanie ekstrennoi hiryrgicheskoi pomoshi v Rossiiskoi Federacii / A.Sh. Revishvili, A.V. Fedorov, V.P. Sajin, V.E. Olovyannii // Hiryrgiya. Jyrnal im. N.I. Pirogova. - 2019. - N 3. - S. 88-97.


2. Lobakov A.I. Sostoyanie ekstrennoi hiryrgicheskoi pomoshi v Moskovskoi oblasti. Problemi i vozmojnie pyti resheniya / A.I. Lobakov, U.I. Zaharov // Almanah klinicheskoi medicini. - 2005. - N 8. - S. 64-68.


3. Informacionnie materiali po ekstrennoi i neotlojnoi hiryrgicheskoi pomoshi pri ostrih hiryrgicheskih zabolevaniyah organov brushnoi polosti v Sankt-Peterbyrge za 2019 god / pod red. prof. V.E. Parfenova. - SPb.: SPb NII SP im. I.I. Djanelidze, 2020. - 30 s.


4. Timerbylatov V.M. Ekstrennaya abdominalnaya hiryrgiya v regione Rossiiskoi Federacii: analiz za 40 let / V.M. Timerbylatov, M.S. Kynafin, M.V. Timerbylatov, R.A. Smir // Vestnik hiryrgii im. I.I. Grekova. - 2013. - T. 172, N6. - S. 89-92.


5. Ermolov A.S. Ekstrennaya hiryrgicheskaya pomosh v Moskve pri ostrih zabolevaniyah organov brushnoi polosti / A.S. Ermolov, N.A. Karasev, A.P. Tyrko // Hiryrgiya. Jyrnal im. N.I. Pirogova - 2009. - N 8. - S. 4-10.


6. Morozov V.S. Sostoyanie ekstrennoi abdominalnoi hiryrgicheskoi slyjbi v Ylyanovskoi oblasti / Morozov V.S., Smolkina A.V., Eremina O.V., Midlenko I.I. // Materiali 54 mejregionalnoi naychno-prakticheskoi medicinskoi konferencii. - 2019. - S. 655-657.


7. Balashova L.A. Sostoyanie organizacii hiryrgicheskoi slyjbi / Balashova L.A. // Materiali naychno-prakticheskoi konferencii vrachei Rossii s mejdynarodnim ychastiem, posvyashennoi 60-letiu kafedri obshei hiryrgii Tverskogo gosydarstvennogo medicinskogo yniversiteta. Pod redakciei E.M. Mohova. - 2015. -S. 4-5.


8. Teplov V.M. Organizaciya raboti otdeleniya hiryrgicheskoi reanimacii mnogoprofilnogo stacionara, okazivaushego ekstrennyu medicinskyu pomosh / Teplov V.M., Shah B.N., Smirnov D.B., Komedev S.S // Vestnik ekstrennoi medicini. - 2013. - N3. - S. 33-34.


9. Yablonskii P.K. Osnovnie statisticheskie parametri okazaniya medicinskoi pomoshi bolnim ostrimi hiryrgicheskimi zabolevaniyami organov brushnoi polosti v Sankt-Peterbyrge / Yablonskii P.K., Movchan K.N., Sokolovich E.G., Yakovenko T.V., Tarasov A.D., Bogolubov M.V., Mamicheva O.U. // Vestnik Novgorodskogo gosydarstvennogo yniversiteta im. Yaroslava Mydrogo. - 2013. - T. 1. - N 71. - S. 64-70.


10. Skryabin O.N. Rezyltati deyatelnosti specialistov krypnogo klinicheskogo medicinskogo ychrejdeniya Sankt-Peterbyrga po profilu «Ekstrennaya abdominalnaya hiryrgiya» s pozicii ocenki kachestva medicinskoi pomoshi v ramkah vedomstvennogo kontrolya / Skryabin O.N. Movchan K.N., Vovk A.V., Tatarkin V.V., Chernishev D.A. // Vestnik Severo-Zapadnogo gosydarstvennogo medicinskogo yniversiteta im. I.I. Mechnikova. - 2019. - T. 11. - N 2. - S. 13-26.