surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2025-15-4-402-414surgonco-1153Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSРоль нарушений микроциркуляции в развитии послеоперационных осложнений в абдоминальной хирургииEffects of Microcirculation Disorders on the Development of Postoperative Complications in Abdominal Surgeryhttps://orcid.org/0000-0002-0631-5666РыжковИ. А.RyzhkovI. A.

Рыжков Иван Александрович — к.м.н, ведущий научный сотрудник, лаборатория экспериментальных исследований

Москва 

Ivan A. Ryzhkov — Cand. Sci. (Med.), Leading Researcher, Laboratory of Experimental Research

Moscow 

iryzhkov@fnkcrr.ruhttps://orcid.org/0000-0003-4420-1923ВарнаковаЛ. А.VarnakovaL. A.

Варнакова Лидия Александровна — младший научный сотрудник, лаборатория экспериментальных исследований

Москва 

Lidia A. Varnakova — Junior Researcher, Laboratory of Experimental Research

Moscow 

https://orcid.org/0009-0000-7224-7131ФоноваП. А.FonovaP. A.

Фонова Полина Александровна — младший научный сотрудник, лаборатория экспериментальных исследований

Москва 

Polina A. Fonova — Junior Researcher, Laboratory of Experimental Research

Moscow 

НИИ общей реаниматологии им. В. А. Неговского Федерального научно-клинического центра реаниматологии и реабилитологииРоссияV.A. Negovskiy Scientific Research Institute of General Resuscitation, Federal Scientific and Clinical Centre of Intensive Care Medicine and RehabilitologyRussian Federation202524122025154402414Copyright © Рыжков И.А., Варнакова Л.А., Фонова П.А., 20252025Рыжков И.А., Варнакова Л.А., Фонова П.А.Ryzhkov I.A., Varnakova L.A., Fonova P.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/1153

Послеоперационные осложнения являются насущной проблемой клинической медицины, ухудшая прогноз и повышая риск летального исхода у хирургических пациентов, особенно в абдоминальной и онкологической хирургии. Согласно современным представлениям микроциркуляторная дисфункция является важным патофизиологическим фактором, лежащим в основе гипоперфузии тканей и развития неблагоприятных послеоперационных исходов. В данном обзоре обобщены современные данные о взаимосвязи между нарушениями микроциркуляции (в области операции и в организме в целом) и послеоперационными осложнениями в абдоминальной хирургии. В обзоре рассматриваются следующие вопросы: (1) эпидемиология послеоперационных осложнений и актуальность этой проблемы в клинической хирургии и реаниматологии; (2) патофизиология периоперационных микроциркуляторных нарушений, включая геморрагический шок, диссеминированное внутрисосудистое свертывание (ДВС-синдром) и эндотелиальную дисфункцию; (3) органоспецифические изменения микроциркуляции при хирургических заболеваниях; (4) современные методы диагностики и мониторинга для оценки тканевой перфузии; (5) прогностическое и диагностическое значение ряда параметров микроциркуляции; и (6) современные терапевтические подходы к оптимизации тканевой перфузии и профилактике осложнений. Понимание важной роли микроциркуляции в обеспечении перфузии и оксигенации тканей обосновывает применение методов интенсивной терапии, ориентированных на микроциркуляцию и, следовательно, предупреждение ишемии органов и риска инфекционных и других послеоперационных осложнений.

Postoperative complications represent a pressing issue of clinical medicine, worsening the prognosis and increasing the risk of death in surgical patients, especially in abdominal and oncological surgery. According to contemporary concepts, microcirculatory dysfunction appears to be an important pathophysiological factor underlying tissue hypoperfusion and development of unfavorable postoperative outcomes. The present review summarizes current data on the relationship between microcirculation disorders both in the surgical area and body as a whole and postoperative complications of abdominal surgery. The review addresses the following issues: (1) epidemiology of postoperative complications and its relevance in clinical surgery and resuscitation; (2) pathophysiology of perioperative microcirculatory disorders, including hemorrhagic shock, disseminated intravascular coagulation (DIC) and endothelial dysfunction; (3) organ-specific changes in microcirculation in surgical diseases; (4) contemporary diagnostic and monitoring methods for tissue perfusion assessment; (5) prognostic and diagnostic value of a number of microcirculation parameters; (6) contemporary therapeutic approaches to tissue perfusion optimization and complication prevention. Understanding the important role of microcirculation in ensuring tissue perfusion and oxygenation justifies the use of intensive care methods focused on microcirculation and thus the prevention of organ ischemia, infectious and other postoperative complications.

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The authors declare that there are no conflicts of interest present.