RESUMO
The authors examined the efficacy of the biospecific antiprotease hemosorption Ovosorb containing ovomucoid from duck egg protein as part of polyacrylamide gel, which was used in the multimodality treatment for experimental diffuse pyoperitoneum and acute destructive pancreatitis in dogs. Ovosorb effectively diminished proteasemia, restored the plasma inhibitory potential by eliminating dysproteinemia, suppressed the production of secondary peptide endotoxins. These effects of the hemosorbent promoted the regression of endotoxicosis and the significant reduction in experimental animal deaths.
Assuntos
Ovomucina/uso terapêutico , Pancreatite/terapia , Peritonite/terapia , Inibidores de Proteases/uso terapêutico , Doença Aguda , Animais , Terapia Combinada , Cães , Feminino , MasculinoAssuntos
Infecções Bacterianas/tratamento farmacológico , Ceftizoxima/uso terapêutico , Adulto , Infecções Bacterianas/complicações , Infecções Bacterianas/metabolismo , Ceftizoxima/farmacocinética , Criança , Humanos , Inflamação/tratamento farmacológico , Inflamação/etiologia , Inflamação/metabolismo , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/metabolismo , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/metabolismoRESUMO
The authors studied the character of the therapeutic action of some links of protein metabolism in connection with the use of hemosorption with a biospecific antiprotease hemosorbent "ovosorb" in the complex treatment of 24 patients with diffuse purulent peritonitis of appendicular genesis. It was found that the antiprotease biospecific hemosorbent is marked by high efficacy in the correction of protein metabolism and the consequent systemic disorders in patients with peritonitis of an appendicular genesis. It is shown that "ovosorb" removes selectively from hemocirculation active forms of proteinase of their complexes with inhibitors and, in contrast to carbon sorbents does not possess unspecific sorption of the inhibitors of proteinases and other blood plasms proteins.
Assuntos
Apendicectomia , Apendicite/cirurgia , Drenagem , Hemoperfusão/métodos , Perfuração Intestinal/terapia , Ovomucina/uso terapêutico , Peritonite/terapia , Doença Aguda , Apendicite/complicações , Proteínas Sanguíneas/efeitos dos fármacos , Terapia Combinada , Humanos , Perfuração Intestinal/etiologia , Ovomucina/farmacologia , Peritonite/sangue , Peritonite/etiologia , Peritonite/patologia , Cuidados Pós-Operatórios , Ruptura Espontânea , SupuraçãoRESUMO
The effect of hemosorption on motor-evacuatory intestinal function was studied in 169 patients with different forms of peritonitis of appendicular genesis. Early inclusion of hemosorption into the complex of treatment contributed to restoration of motor-evacuatory function of the intestine in 2-3 days, as well as to prevention of development of early commissural ileus.
Assuntos
Hemoperfusão/métodos , Obstrução Intestinal/prevenção & controle , Peritonite/terapia , Idoso , Motilidade Gastrointestinal , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/fisiopatologia , Pessoa de Meia-Idade , Peritonite/complicações , Peritonite/fisiopatologia , Cuidados Pós-Operatórios/métodos , Aderências TeciduaisAssuntos
Mucosa Gástrica/inervação , Regeneração Nervosa/fisiologia , Úlcera Péptica/cirurgia , Complicações Pós-Operatórias/etiologia , Vagotomia Gástrica Proximal/efeitos adversos , Nervo Vago/fisiopatologia , Ácido Gástrico/metabolismo , Mucosa Gástrica/metabolismo , Humanos , Úlcera Péptica/etiologia , Recidiva , Vagotomia Gástrica Proximal/métodos , Nervo Vago/cirurgiaRESUMO
Analysis of the results of treatment of 240 patients with generalized peritonitis of appendicular origin showed that the application of hemosorption led to noticeable and stable diminution of intoxication in 84% of cases. In the ++post-sorption period, the severity of endotoxicosis did not change essentially in 12% of cases and increased in the remaining cases. The therapeutic effect of hemosorption was found to be unstable in patients with signs of multiple organ insufficiency developing in prolonged poorly effective therapy as well as in patients with unrecognized abdominal abscesses, incompetence of the sutures of anastomoses, thrombosis of the mesenteric vessels, and early intestinal obstruction due to adhesions. Endotoxicosis intensified during hemosorption in patients with extensive epifascial phlegmons. It is proved that hemosorption applied repeatedly in the early postoperative period with due account for the individual features of the course of the disease ensures an optimal therapeutic effect.