surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2024-14-2-174-179surgonco-954Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSИнтраабдоминальная гипертензия и абдоминальный компартмент-синдром. Обзор литературыIntra-Abdominal Hypertension and Abdominal Compartment Syndrome. Literature Reviewhttps://orcid.org/0000-0002-4832-6363ТимербулатовШ. В.TimerbulatovSh. V.

Тимербулатов Шамиль Вилевич — д.м.н., кафедра хирургии и эндоскопии

Республика Башкортостан, Уфа

Shamil V. Timerbulatov — Dr. Sci. (Med.), Prof., Department of Surgery and Endoscopy

Ufa

АбдуллинУ. М.AbdullinU. M.

Абдуллин Урал Маратович — к.м.н., доцент, кафедра топографической анатомии и оперативной хирургии

Республика Башкортостан, Уфа

Ural M. Abdullin — Cand. Sci. (Med.), Assoc. Prof., Department of Topographic Anatomy and Operative Surgery

Ufa

https://orcid.org/0000-0001-5260-2319ВикторовВ. В.ViktorovV. V.

Викторов Виталий Васильевич — д.м.н., профессор, кафедра факультетской педиатрии и неонатологии

Республика Башкортостан, Уфа

Vitalii V. Viktorov — Dr. Sci. (Med.), Prof., Department of Faculty Pediatrics and Neonatology

Ufa

https://orcid.org/0000-0002-6085-2673ПлечевВ. В.PlechevV. V.

Плечев Вячеслав Владимирович — студент 6-го курса

Республика Башкортостан, Уфа

Vyacheslav V. Plechev — 6th year student

Ufa

https://orcid.org/0000-0003-2874-7213ГафароваА. Р.GafarovaA. R.

Гафарова Айгуль Радиковна — кафедра хирургии и эндоскопии

Республика Башкортостан, Уфа

Aigul R. Gafarova — Department of Surgery and Endoscopy

Ufa

argafarova@yandex.ruБашкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian Federation202405072024142174179Copyright © Тимербулатов Ш.В., Абдуллин У.М., Викторов В.В., Плечев В.В., Гафарова А.Р., 20242024Тимербулатов Ш.В., Абдуллин У.М., Викторов В.В., Плечев В.В., Гафарова А.Р.Timerbulatov S.V., Abdullin U.M., Viktorov V.V., Plechev V.V., Gafarova A.R.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/954

Интраабдоминальная гипертензия и  абдоминальный компартмент-синдром остаются сложной проблемой абдоминальной хирургии. Ввиду разнообразных этиологических факторов, ведущих к повышению интраабдоминального давления (воспалительные, деструктивные процессы, травмы, сепсис, послеоперационные осложнения и др.), отрицательного влияния повышенного ИАД на функции гастроинтестинальной, дыхательной, сердечно-сосудистой систем, почек, центральную нервную систему, своевременная диагностика и лечение играют важную роль. Постепенно повышенное внутрибрюшное давление может вызвать стойкую дисфункцию органов и быть потенциально фатальным. На сегодня достаточно глубоко изучены патофизиологические механизмы, методы определения интраабдоминального давления, частоты его измерения, методы консервативного и хирургического лечения. В статье представлен обзор литературы по проблеме внутрибрюшной гипертензии и абдоминального компартмент-синдрома. Рассматриваются вопросы эпидемиологии, показатели летальности, методы измерения внутрибрюшного давления, в  том числе современные инновационные технологии. Представлены основы клинической диагностики, значение и  информативность дополнительных биохимических исследований крови, лучевых методов, преимущественно компьютерной томографии, ультразвукового исследования. Рассмотрены современные методы консервативного лечения, которые при раннем их применении существенно минимизируют повреждение органов-мишеней, органную дисфункцию, показания к экстренной декомпрессивной лапаротомии. Приведены также рекомендации по послеоперационному ведению пациентов с «открытым» животом, по оптимальным срокам закрытия лапаростомы.

Intra-abdominal hypertension and abdominal compartment syndrome remain a challenging problem in abdominal surgery. Due to various etiological factors leading to increased intra-abdominal pressure (inflammatory, destructive processes, trauma, sepsis, postoperative complications, etc.), and the negative impact of increased IBP on the functions of the gastrointestinal, respiratory, cardiovascular systems, kidneys, central nervous system, timely diagnosis and treatment play an important role. Gradually elevated intra-abdominal pressure can cause persistent organ dysfunction and be potentially fatal. To date, the pathophysiological mechanisms, methods for determining intra-abdominal pressure, the frequency of its measurement, and methods of conservative and surgical treatment have been studied in sufficient detail. The paper presents a literature review on the problem of intra-abdominal hypertension and abdominal compartment syndrome. The study considers issues of epidemiology, mortality rates, methods for measuring intra-abdominal pressure, including advanced innovative technologies. The authors present the basics of clinical diagnosis, the significance and informativity of additional biochemical blood tests, radiation methods, mainly computed tomography, and ultrasound examination. Advanced methods of conservative treatment are considered, which, when used early, significantly minimize target organ damage, organ dysfunction, and indications for emergency decompressive laparotomy. Finally, recommendations are given for the postoperative management of patients with an “open” abdomen, and for the optimal timing of laparostoma closure.

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