From Big Medical Encyclopedia

COMPLICATION — the pathological process arising in connection with features of a pathogeny of primary (main) disease at this patient or as the unexpected investigation of the held diagnostic and medical events, secondary in relation to the available disease. O.'s emergence is promoted by disturbance by patients ordered diets, the mode of a physical activity, Regulations of Admission of the appointed drugs.

Wedge, value O. is defined by the fact that quite often they develop sharply and in itself can pose a threat to life of the patient. In these cases O.'s emergence demands carrying out urgent to lay down. actions, to-rye sometimes complicate treatment of a basic disease.

In relation to terms of a current of a basic disease distinguish the early O. i.e. arising at early stages of a disease, usually in its acute period and late O. E.g., after operation for an acute appendicitis treat infiltrate in the field of an operational wound early O., sacculated an abscess in an abdominal cavity, bleeding from a mesentery, fecal fistula; to late — commissural process in an abdominal cavity.

As O. can be considered in some cases and accession to a basic disease of other disease, emergence a cut is in pathogenetic dependence on the basic patol, process (e.g., development of a septic endocarditis at an open botallovy channel).

Treat the most frequent O. which are found at various diseases acute cardiovascular and respiratory insufficiency, funkts, insufficiency of kidneys and a liver, bleeding, thromboembolic and infectious O., disturbances water and electrolytic and acid-base equilibrium. Joining of one or several of these terrible frustration, as a rule, sharply burdens a current of a basic disease; sometimes O. acts into the forefront, getting a role of the leader patol, process and defining a direct outcome of the disease (pneumonia and thromboembolisms in the postoperative period, especially at elderly people and the weakened patients).

The reasons and origins of O. are diverse and at different diseases are not identical. Quite often the features of development of a basic disease leading to O.'s emergence are caused by individual deviations in an organism of the patient, existence at it functional or morfol, disturbances — inborn or acquired (connected, e.g., with advanced age, the postponed diseases). Often O. are the cornerstone hemodynamic disturbances with falloff of blood supply of bodies, their ischemia and a hypoxia (disturbance of cerebral and coronary circulation, an acute renal failure, acute stomach ulcer and intestines); disturbances of water and electrolytic exchange (a disease with the expressed gastric and intestinal dyspepsia resulting in sharp deficit of potassium, sodium and water); a scattered intravascular blood coagulation (at shock, massive bleeding, hemolitic and trombotsitoliti-chesky syndromes); neurometastasis ad nervos (a coronary spasm at cholelithiasis, trophic frustration at a serious poisoning carbon monoxide); change of nonspecific resistance of an organism (a syndrome of deficit of antibodies at burns, tumors, a heavy nephrotic syndrome, etc.). A specific place among O. is held medicinal allergy (see), and also the allergic O. arising at an endogenous sensitization at patients hron, colitis, hron, gastritis with insufficiency of secretory function, hron, hepatitis and cholecystitis. From O. connected with the applied treatment the most frequent are O. caused by side effect pharmaceuticals (see), and O. connected with surgery. The last depending on terms of their emergence divide into the accompanying operations (arise on the operating table), O. of the postoperative period and remote.

Lakes can be observed as a result of the manipulations made with diagnostic and to lay down. purposes: bleedings and suppurations after a puncture biopsy of bodies and fabrics, dysfunctions of pelvic bodies after a pnevmomiyelografiya, etc.

The diagnosis is based on the correct interpretation considered patol, process and its communication with a basic disease.

It is necessary to distinguish natural displays of a disease from O. in the form of acute, sometimes vitally dangerous frustration, napr, anuries at acute nephrite and toxic damages of kidneys; the intercurrent diseases which are not connected with the main disease neither on an etiology, nor on the mechanism of development, napr, intra-hospital infection with dysentery, flu, ORZ do not belong to complications. The processes developing in connection with medical errors are not considered as O. and patol (disturbance of the technology of surgery, incompatible blood transfusion, etc.).

Late O. cannot be mixed with the remote effects of a disease in the form of permanent changes of the separate bodies and fabrics or diseases caused by the postponed suffering. So, at transferred an acute radial illness development acute and hron, leukoses, tumors, a cataract, nek-ry endocrine diseases is possible.

Prevention of complications is the major element to lay down. process. Its efficiency is defined by the level of the organization of work in to lay down. establishment and training of medical staff. Success of prevention of O. is defined by timeliness, adequacy and full value of treatment of a basic disease, the differentiated approach to purpose of diagnostic testings, the rational motive mode, to lay down. food, and also careful nosotrophy.

Postoperative O.' prevention includes carrying out to lay down. - professional, actions in preoperative period (see), including the prevention of an intrahospital infection in surgical departments, psychological training of patients for operation, elimination of the active centers of an infection, increase in nonspecific resistance of an organism, purpose of cardiac glycosides by the patient with changes of a myocardium, etc., and in postoperative period (see) — to lay down. gymnastics, massage, correction of disturbances in coagulant system of blood, etc.

See also Disease

G. I. Alekseev.