[Comparative estimation of efficacy of the immunecorrecting combined three- level cytokino- and ozonotherapy in complex treatment of extended peritonitis].

The results of surgical treatment of 211 patients, suffering extended peritonitis (EP) of various etiology, were analyzed. The peritonitis severity was graded in accordance to Mannheim's index of peritonitis (MIP). The patients were divided on two groups. In 60 patients (group of comparison) the basic treatment was conducted, without immunocorrection. The patients of the main group were divided on three subgroups. To the patients of the first subgroup (43) 400 ml of ozonated isotonic solution (OIS) of sodium chloride was infused intravenously additionally in the contents of basic therapy, as well as peritoneal-enteral detoxication using OIS was conducted. In a second subgroup a regional intraabdominal endolymphatic ozonotherapy (OTH) was conducted to 57 patients with OIS and peritoneal-enteral sanation using medical ozone. In the 3d subgroup in 51 patients additionally were applied intravenous infusion of OIS and peritoneal-enteral sanation with medical ozone. To these patients cytokinotherapy was conducted, when splenopid was applied intravenously, intraperitoneally and enterally simultaneously. The indices of the T- and B-immunity links, phagocytic activity of neutrophils, including phagocytic index, phagocytic number, the completeness of phagocytosis index, as well as the content of the tumor necrosis factor alpha (TNF-alpha), gamma-interferon (IFN-gamma) and interleukins (IL) - IL-1, IL-2, IL-4, IL-6, IL-10 were estimated in the blood serum in dynamics. The combined staged three-level (systemic, intraperitoneal and enteral) application of natural cytokins and medical ozone have promoted mutual potentiating of their action, significant efficacy of the immunemodulating therapy in comparison with such systemic and local OTH.

[The influence of ozone therapy to some immunological parameters in patients with generalized peritonitis].

The immune status of the surgical treatment of 103 patients with generalized peritonitis (GP) were discussed. Patients were divided into two groups. Comparison group included 60 patients who received conventional combined therapy, main group - 43 patients, who, along with the standard complex treatment measures, were used local and systemic intravenous ozone therapy (OT). The severity state of patients evaluated by Mannheim peritoneal index (MPI). To assess the immune status in blood of the patients with GP were studied the level of lymphocyte subpopulations (CD3+, CD4+, CD8+, CD11a+, CD19+), the phagocytic activity of neutrophilic granulocytes, concentration of immunoglobulin A, M, G, and the content of circulating immune complexes (CIC). Studies have shown that GP is accompanied by changes in the functioning of the immune system, the severity and extent of which depends on the severity of MPI. The conventional basic therapy is not effective in correcting of these disturbances. Using the local and systemic OT in the complex of therapeutic measures in individually selected patients with GP have a positive effect on some level of immunity with a tendency to restore the immune system dysfunction.