The medical term "paresis" in translation fromGreek "πάρεσις" denotes attenuation. Paresis is the weakening of voluntary movements, a special neurological syndrome caused by damage to the motor centers of the brain and / or spinal cord, as well as the conducting pathways of the peripheral and central nervous systems. Deep paresis, also called plethysy or paralysis (with Greek "παράλυσις" - relaxation) is the absolute absence of arbitrary movements, which is due to the same reasons as paresis.
Paresis and deep paresis (paralysis) aremotor disorders due to damage to the pyramidal system of the brain. Very often, after surgical interventions develop intestinal paresis, which can also be accompanied by an expansion of the stomach. In this case, the paresis of the intestine is caused by a violation of water and electrolyte balance, as well as an operating trauma. Besides. intestinal paresis often occurs when there is hypokalemia, which develops due to blood loss during surgery or as a result of profuse multiple vomiting in the postoperative period.
In most cases, paresis of the intestine developson the second-third day after the operation. This condition requires immediate therapy, as the intestinal dilated as a result of the paresis further exacerbates the existing electrolyte disturbances, and also contributes to the development of intoxication. Sometimes in very weakened patients against paresis, peritonitis develops. In addition to the so-called postoperative paresis, paresis of the intestine in children, which occurs due to hypoxia, microcirculatory disturbances in the intestine, and increased gas formation, is quite common.
The first and, perhaps, the main symptom of the paresisthe intestine is its swelling, which is often accompanied by bloating. The condition worsens with the accumulation and retention of gases and with the increase of swelling of the intestine. As a result of stagnation in the contents of the intestine, rotting processes develop in it, and the accumulation of gases increases. At the same time, damaged and distended intestinal walls, which are unable to suck in the gas, react to these processes by increased release of mucus and liquid. In addition, there are irreversible changes in intestinal walls and there is dehydration of tissues, the volume of circulating blood decreases - and the state of "protoplasmic shock" comes.
A special place in the diagnosis of intestinal paresisbelongs to X-ray examination, which begins with an overview radiograph of the abdomen. The examination is carried out in two patient positions: horizontal and vertical.
Paresis of the intestine: treatment and prevention
Depending on the mechanism of development of the paresis and its transition to acute intestinal obstruction, therapeutic and preventive measures are carried out in several main directions.
First, the implementation of surgical interventions should be carried out with careful observance of the principles of gentle technique, which is an important element in the prevention of postoperative paresis.
In the presence of an obvious threat of paresis development, for example, in acute pancreatitis, severe abdominal and lumbar injuries, it is necessary to continuously emptying the stomach with a probe.
In addition, blockade of sympatheticinnervation, which is achieved novocaine paranephric blockade. With the threat of development of dynamic obstruction and for the treatment of persistent paresis, the most effective is the peridural blockade.
The next direction of medical influence onfighting with paresis is the use of methods of reflex stimulation of intestinal motility, such as abdominal wall massage, oil, etheric or semi-alcohol compresses, curative enemas and irritation with a gas outlet tube of the rectum.</ p>