Биология ва тиббиёт муаммолари 2026, №5 (171)
Subject of the article
DOPPLEROGRAPHIC EVALUATION OF INTESTINAL WALL BLOOD FLOW IN CHILDREN WITH ACUTE INTESTINAL OBSTRUCTION (263-268)
Authors
Otamuradov Furqat Abdukarimovich, Vohobov Nodir Safarovich, Kurbaniyazov Bakhodir Zafarjonovich
Institution
1 - Termez Branch of Tashkent State Medical University, Republic of Uzbekistan, Termez; 2 - Samarkand State Medical University, Republic of Uzbekistan, Samarkand
Abstract
Aim: to compare the outcomes of a prognosis-based differentiated algorithm with conventional tactics in chil-dren with acquired acute intestinal obstruction. Materials and methods: a single-centre ambispective cohort compared a main group of 82 children managed by an algorithm with scheduled recalculation of a prognostic score at 6 and 12 hours against a historical control group of 104 children; the groups did not differ in any base-line feature, including the distribution of risk groups (p = 0.917). Results: the algorithm cut the operated share from 41.3% to 25.6% (p = 0.025), the bowel-resection rate from 22.1% to 4.9% (odds ratio 0.18; p < 0.001) and operations later than 24 hours from admission from 16.3% to 3.7% (p = 0.006). Complications fell from 15.4% to 6.1% (p = 0.047), with no deaths and no anastomotic leaks against three in controls. Laparoscopy was the first procedure in 81.0% versus 55.8% of operated children, and the median time to surgery shortened from 14.2 to 7.0 hours. The number needed to treat to prevent one resection was six, and the Mantel–Haenszel odds ratio for resection was 0.13 (p = 0.001). Conclusion: a score-driven algorithm safely shifts management toward early minimally invasive intervention without lengthening hospital stay.
Key words
acute intestinal obstruction, children, prognostic score, bowel resection, laparoscopy, differentiated tactics.
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