Патогенетическая роль гормонов в образовании острых эрозий и язв гастродуоденальной зоны при сочетанной черепно-мозговой травме

Abstract

The examination of 60 patients aged 15-65 years with concomitant severe craniocerebral injuries has been carried out. Depending on the combination of traumas the patients have been subdivided into the following groups: 1) 20 patients with the combination of thorax and lungs injuries, 2) 20 patients with the combination of abdominal cavity injuries, 3) 20 patients with the combination of extremities and pelvic bones fractures. The analysis of hormones has been conducted using the method of electrohemoluminiscence of the blood serum. The results of the analysis have been compared with the results of the examination of 20 healthy persons selected for a control group. Along with endoscopic examinations the determination of the hormones in the patients with combined traumas has been conducted on the 3d , 5th and 7th days. On the 5th day the exacerbation of inflammatory processes in the mucous membranes has been established as well as the presence of acute erosive gastroduodenitis and mainly muco-biliary mixture in the stomach medium. On the seventh day already, along with the sharp erosive gastroduodenitis, acute small size ulcers, identified in the different areas of the stomach, the congestive environment has been identified in the stomach together with muco-biliary mixture. As a result of the studies the high hormone levels have been found in the patients with concomitant injuries on all the days of the survey in comparison with the observation control group. The increase of the hormone level in the blood of the patients with concomitant severe craniocerebral traumas leads to the disruption of motor functions in the gastroduodenal zone and the growth of bile acids in the gastric environment. The increase of gastric acidity in these patients leads to the destruction of duodenal environment and polymer gel structure of the gastric mucus, to the reflux of bile into the stomach, to the destruction of aggressively-protective characteristics and the formation of acute erosions and ulcers of the mucous membranes.