[Serum myoglobin as an indicator of endotoxicosis in acute intestinal obstruction]

To give objective assessmed of endotoxicosis, the authors for the first time have studied blood myoglobin as a marker of tissue hypoxy in 84 patients with acute obstruction of the small bowel. A strong correlation between serum myoglobin level and clinical manifestations of endotoxicosis was established. It enables the authors to recommend the study of myoglobin values in patients for quick and objective evaluation of endotoxicosis. As a result of comparative analysis of the pronouncement of clinical and roentgenological symptoms as well as changes in laboratory findings and among them--myoglobin level in 427 patients with acute intestinal obstruction, the authors demonstrate 5 stages of clinical course of the disease. Th stage of ischemia was in 48.9% patients. In 22% of them manifestations of obstruction were eliminated by conservative means, 26.9% of patients of this stage were operated. The stage of water-electrolyte balance disturbances was detected in 26.2% of patients. The stage of peritonitis was detected in 15.9% of patients. The stage of multiorganic insufficiency was revealed in 8.9% of patients. All of these patients were operated. The stage of rehabilitation took from 2 months to 3 years after the operation. Conservative symptomatic treatment was used in all these patients. It was established that maximal informativevalue of myoglobin study was achieved in patients at the stages of water-electrolyte balance disturbances, in peritonitis and polyorganic insufficiency. The results of the examinations allows evaluation of the stage of endotoxicosis, prediction of the course of the disease and assessment of the effectiveness of detoxication therapy.