The medical term "paresis" in translation from Greek "πάρεσις" means weakening. Paresis is a 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 pathways of the peripheral and central nervous systems. Deep paresis, also called plegia or paralysis (from the Greek. "Παράλυσις" - relaxation) is the absolute absence of voluntary movements, which is due to the same reasons as paresis.
Paresis and deep paresis (paralysis) are motor disorders caused by damage to the pyramidal system of the brain. Very often after surgical interventions, paresis of the intestine develops, which can also be accompanied by an expansion of the stomach. In this case, intestinal paresis is caused by a violation of the water and electrolyte balance, as well as operating trauma. Besides. intestinal paresis often occurs in the presence of hypokalemia, which develops as a result of blood loss during surgery or as a result of copious repeated vomiting in the postoperative period.
In most cases, intestinal paresis develops on the second or third day after surgery. This condition requires immediate treatment, since the intestines expanded as a result of paresis further aggravate the existing electrolyte disturbances, and also contributes to the development of intoxication. Sometimes in very weakened patients, peritonitis develops against the background of paresis. In addition to the so-called postoperative paresis, quite often intestinal paresis occurs in children, resulting from hypoxia, impaired microcirculation in the intestine and increased gas formation.
The first and, perhaps, the main symptom of paresis of the intestine is its bloating, which is often associated with bloating. The condition worsens with the accumulation and delay of gases and with an increase in bloating. As a result of stagnation of the contents of the intestine, the processes of decay develop in it, the accumulation of gases increases. At the same time, damaged and distended intestinal walls, which are unable to absorb gas, react to these processes by increased secretion of mucus and fluid. In addition, irreversible changes in the walls of the intestine occur and tissue dehydration occurs, the volume of circulating blood decreases, and the state of “protoplasmic shock” sets in.
A special place in the diagnosis of intestinal paresis belongs to x-ray examination, which begins with a survey radiography of the abdomen. The examination is carried out in two positions of the patient: horizontal and vertical.
Intestinal paresis : treatment and prevention
Depending on the mechanism of development of paresis and its transition into acute intestinal obstruction, therapeutic and preventive measures are carried out in several main directions.
Firstly, the implementation of surgical interventions should be carried out with careful observance of the principles of gentle technology, which is an important element in the prevention of postoperative paresis.
In the presence of an obvious threat of paresis, for example, with acute pancreatitis, severe injuries of the abdomen and lumbar region, it is necessary to constantly empty the stomach with a probe.
In addition, a blockade of sympathetic innervation is used, which is achieved by novocaine paranephral blockade. With the threat of developing dynamic obstruction and for the treatment of persistent paresis, epidural block is the most effective.
The next direction of the therapeutic effect on the fight against paresis is the use of methods of reflex stimulation of intestinal motility, such as massage of the abdominal wall, oil, ether or half-alcohol compresses, therapeutic enemas and irritation with the vent tube of the rectum.