research-focus Research Focus International Scientific Journal Research Focus 2181-3833 Ilm-fan va innovatsiyalar akademiyasi 10.66073/researchfocus.v5i2.2053 REL-A-013346 14.00.00 PATHOGENETICALLY BASED CONSERVATIVE THERAPY IN THE COMPLEX TREATMENT OF ACUTE ADHESIVE SMALL BOWEL OBSTRUCTION ПАТОГЕНЕТИЧЕСКИ ОБОСНОВАННАЯ КОНСЕРВАТИВНАЯ ТЕРАПИЯ В КОМПЛЕКСНОМ ЛЕЧЕНИИ ОСТРОЙ СПАЕЧНОЙ ТОНКОКИШЕЧНОЙ НЕПРОХОДИМОСТИ O‘TKIR BITISHMALI INGICHKA ICHAK TUTILISHINI KOMPLEKS DAVOLASHDA PATOGENETIK ASOSLANGAN KONSERVATIV TERAPIYA Choriev Khaitmurod Kultura ugli Samarkand State Medical University and the Termez Branch of Tashkent State Medical University Mustafakulov Ishnazar Boynazarovich Samarkand State Medical University and the Termez Branch of Tashkent State Medical University Djuraeva Zilola Aramovna Samarkand State Medical University and the Termez Branch of Tashkent State Medical University 05 03 2026 2026 5 2 190 194 https://creativecommons.org/licenses/by/4.0 This work is licensed under a Creative Commons Attribution 4.0 International License.

Acute adhesive small bowel obstruction (ASBO) remains one of the most common causes of emergency abdominal surgery and is characterized by a high risk of complications and recurrence. Conservative treatment is effective only in some patients, and the lack of a pathogenetic approach limits its results. This study utilized a diagnostic algorithm using clinical, laboratory, and instrumental criteria. The use of a comprehensive conservative approach was associated with favorable clinical outcomes and improved motor-evacuation function, as measured by laboratory, radiographic, and ultrasound examinations. Post-treatment duplex ultrasound imaging revealed statistically significantly higher Vmax and Vmin values in patients with localized adhesions compared to those with widespread adhesions (p<0.001). This pathogenetically substantiated comprehensive conservative therapy is an effective component of OSTKO treatment and can be used to increase the rate of successful non-surgical resolution of the disease and optimize the choice of subsequent treatment.

Острая спаечная тонкокишечная непроходимость (ОСТКН) остаётся одной из наиболее частых причин экстренной абдоминальной хирургии и характеризуется высоким риском осложнений и рецидивов. Консервативное лечение эффективно лишь у части пациентов, а отсутствие патогенетического подхода ограничивает его результаты. В рамках исследования применён диагностический алгоритм с использованием клинических, лабораторных и инструментальных критериев. Применение комплексной консервативной методики сопровождалось благоприятными клиническими исходами и улучшением показателей моторно-эвакуаторной функции по данным лабораторн ых, рентгенологических и ультразвуковых исследований. По данным УЗ-дуплексного сканирования после лечения у больных с ограниченными спайками отмечались статистически значимо более высокие значения Vmax и Vmin по сравнению с пациентами с распространёнными спайками (p

O‘tkir chandiqli ingichka ichak tutilishi (O‘ChIIT) shoshilinch abdominal xirurgiyaning eng ko‘p uchraydigan sabablaridan biri bo‘lib qolmoqda hamda asoratlar va qaytalanish (retsidiv) xavfining yuqoriligi bilan xarakterlanadi. Konservativ davolash faqat bemorlarning bir qismida samarali bo‘lib, patogenetik yondashuvning yetishmasligi uning natijalarini cheklaydi. Tadqiqot doirasida klinik, laborator va instrumental mezonlardan foydalangan holda diagnostik algoritm qo‘llanildi. Kompleks konservativ uslubni qo‘llash ijobiy klinik natijalar va laborator, rentgenologik hamda ultratovush tekshiruvlari ma‘lumotlariga ko‘ra motor-evakuator funksiyasi ko‘rsatkichlarining yaxshilanishi bilan kechdi. Ultratovush dupleks skanerlash ma‘lumotlariga ko‘ra, davolashdan so‘ng chegaralangan chandiqlari bo‘lgan bemorlarda tarqalgan chandiqlari bo‘lgan bemorlarga nisbatan Vmax va Vmin ko‘rsatkichlari statistik jihatdan ishonchli darajada yuqori bo‘lganligi qayd etildi (p

 acute adhesive small bowel obstruction conservative therapy serotonin adipate oxidative stress cytokines microcirculation ultrasound duplex scanning острая спаечная тонкокишечная непроходимость консервативная терапия серотонина адипинат оксидативный стресс цитокины микроциркуляция ультразвуковое дуплексное сканирование o‘tkir chandiqli ingichka ichak tutilishi konservativ terapiya serotonin adipinati oksidativ stress sitokinlar mikrosirkulyatsiya Uzbekistan 191 https:// Oblakulov Z.T., Narzullaev S.I., Mizamov F.O., Shonazarov I.Sh., Murodullaev S.O., Tukhtaev B.Kh. Videolaparoscopic treatment of acute adhesive intestinal obstruction / Achievements of science and education Videolaparoscopy in the examination and treatment of patients with acute small bowel obstruction / M.V. Turbin [et al.] // Clinical and experimental surgery. Journal named after ac. B.V. Petrovsky. - 2020. - Vol. 8, No. 2. - P. 67-72. Orsich, E. O. Factors influencing the severity of the adhesive process / E. O. Orsich, A. S. Zhidkov, S. A. Zhidkov // Modern medicine: current issues. - 2016. - No. 54-55. - P. 138-144. The main aspects of adhesive small intestinal obstruction / M.K. Gulov [et al.] // Avicenna Bulletin. - 2021. - No. 2. - P. 269-279. Basic clinical, diagnostic and therapeutic principles of managing patients with acute adhesive intestinal obstruction / A.A.Sopuev [et al.] // Problems of modern science and education. - 2016. - No. 10 (52). - P. 170-174. Features of diagnosis and treatment of elderly and senile patients with adhesive small intestinal obstruction / B.V. Sigua, [et al.] // Advances in Gerontology. - 2021. - No. 1. - P. 33-38. Acute adhesive small bowel obstruction: laparotomy or laparoscopy / I.S. Malkov [et al.] // Kazan Medical Journal. - 2018. - Vol. 99, No. 3. - P. 508-514. Parshin D. S., Topchiev M. A.,Misrikhanov M.K., Topchiev A.M., Pyatakov S.N., Chechukhina O.B., Smirnyagina E.O. Characteristics of the enteral pathobiome in widespread purulent peritonitis complicated by acute enteric insufficiency syndrome // Modern problems of science and education. 2021. No. 4. P. 56. Polvonov, Sh.B. Pathogenesis, diagnostics and surgical treatment of acute strangulation small intestinal obstruction and its postoperative complications: author's abstract. diss. doctor of medical sciences: 14.01.17 / Polvonov Shukrullo Boboevich. - Dushanbe. - 2017. - 42 p. Polynsky, A.A. Laparoscopy in the diagnosis and treatment of adhesive intestinal obstruction / A.A. Polynsky, I.T. Tsilindz // Actual problems of medicine: materials of the annual final scientific and practical conference, Grodno: Grodno State Medical University. - 2018. - P.634- Anti-adhesion barriers in abdominal surgery: current state of the problem / V. A. Samartsev, [et al.] // Perm Medical Journal. - 2017. - Vol. 34, No. 2. - P. 87-93. Prevention of adhesive disease of abdominal organs in the early postoperative period / V. F. Zubritsky, [et al.] // Medical Bulletin of the Ministry of Internal Affairs. - 2015. - No. 6 (79). - P. 9-11. Radionuclide method in the diagnosis of adhesive small intestinal obstruction / N.E. Kudryashova [et al.] // Bulletin of surgical gastroenterology. - 2017. - No. 4. - P. 3-8.