RESUMO
The article analyzes the results of surgical treatment of 78 patients with generalized peritonitis (GP) between the ages of 18 to 76 years. Severity was assessed by RP Mannheim peritoneal index (MPI). The study was conducted according to a comparative evaluation of the method of treatment in both groups. In the comparison group included 38 patients who received conventional therapy without immune complex. In 40 patients of the study group on the background of complex therapeutic measures in pre- and postoperative additionally used concomitant local and systemic ozone therapy (OT) with ozonatedperftoran (OP). All patients in the dynamics of blood prior to surgery, on the 3rd and 7th day after surgery was determined TNF-α, IL-4 and IL-8 by IFA. In general, patients in both groups at admission were identified imbalance between pro- and anti-inflammatory cytokines. Patients of the main group on the complex background of basic therapy combined local and systemic administration of OP positive effect in terms of acceleration available cytokine imbalance. The complex therapeutic interventions GP application of local and systemic OT with OP accelerates elimination of imbalances in the cytokine profile.
Assuntos
Fluorocarbonos/administração & dosagem , Ozônio , Lavagem Peritoneal/métodos , Peritonite , Administração Intravenosa , Adulto , Idoso , Substitutos Sanguíneos/administração & dosagem , Feminino , Humanos , Interleucina-4/sangue , Interleucina-8/sangue , Masculino , Pessoa de Meia-Idade , Monitorização Imunológica , Oxidantes Fotoquímicos/administração & dosagem , Oxidantes Fotoquímicos/farmacologia , Ozônio/administração & dosagem , Ozônio/farmacologia , Assistência Perioperatória/métodos , Peritonite/tratamento farmacológico , Peritonite/imunologia , Peritonite/fisiopatologia , Peritonite/cirurgia , Índice de Gravidade de Doença , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangueRESUMO
The immune status was studied while surgical treatment of 74 patients, suffering extended peritonitis (EP). In 38 patients (group of comparison) a complex routine therapy was conducted, in 36 (the main group)--along with routine complex measures of treatment a local and systemic ozonotherapy, using ozonized perftoran (OP) and glutoxim (for immunocorrection), were applied. The patients severity state was estimated in accordance to the Mahnheim's peritoneal index. In all the patients while hospitalization there were revealed changes in T--and B--links of immunity, in phagocytosis and the cytokins profile, significant of which have depended upon the EP severity. The combined local and systemic application of OP and glutoxim in complex of conservative treatment is pathogenetically substantiated, it permits more rapidly to eliminate the immunity disorders and the cytokines balance, as well as inflammatory process in abdominal cavity and to improve the results of surgical treatment significantly.
Assuntos
Substitutos Sanguíneos/uso terapêutico , Fluorocarbonos/uso terapêutico , Imunidade Inata/efeitos dos fármacos , Fatores Imunológicos/uso terapêutico , Oligopeptídeos/uso terapêutico , Ozônio/uso terapêutico , Peritonite/tratamento farmacológico , Adolescente , Adulto , Idoso , Linfócitos B/efeitos dos fármacos , Linfócitos B/imunologia , Linfócitos B/patologia , Estudos de Casos e Controles , Quimioterapia Combinada , Feminino , Humanos , Interleucina-4/biossíntese , Interleucina-4/imunologia , Interleucina-8/biossíntese , Interleucina-8/imunologia , Masculino , Pessoa de Meia-Idade , Peritonite/imunologia , Peritonite/patologia , Índice de Gravidade de Doença , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia , Linfócitos T/patologia , Fator de Necrose Tumoral alfa/biossíntese , Fator de Necrose Tumoral alfa/imunologiaRESUMO
Experimental investigations (experiments in 61 dogs) have shown the application of drug occlusion on the gland duct system with cryodestruction of necrosis foci to be a promising method for treatment of pancreonecrosis.