RESUMO
The dynamics of microbial endotoxemia in group of 149 patients with cholelithiasis complicated by obstructive jaundice has been studied as dependent on the perioperative tactics of infusion therapy. The perioperative period in obstructive jaundice patients is complicated by a significant increase in lipopolysaccharidemia caused by translocation mechanisms and disorders of the liver detoxification function. In Group 1, 47 patients received infusion therapy including Ringer's solution and 10% glucose solution at a 1:1 ratio. In group 2, 55 patients received infusion therapy with only Sterofundin G-5 solution. In Group 3, 47 patients received the infusion therapy with remaxol in a dose of 800 ml/day. It is established that the infusion of Sterofundin G-5, and to a greater extent the infusion of remaxol, reduces the early postoperative degree of decompensation and accelerates recovery of the detoxifying function of Kupffer cells with respect to microbial endotoxin.
Assuntos
Colelitíase/tratamento farmacológico , Endotoxemia/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Icterícia Obstrutiva/tratamento farmacológico , Lipopolissacarídeos/sangue , Colelitíase/sangue , Colelitíase/microbiologia , Colelitíase/cirurgia , Endotoxemia/sangue , Endotoxemia/microbiologia , Hidratação , Glucose/farmacologia , Glucose/uso terapêutico , Infecções por Bactérias Gram-Negativas/sangue , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Infusões Parenterais , Soluções Isotônicas/farmacologia , Soluções Isotônicas/uso terapêutico , Icterícia Obstrutiva/sangue , Icterícia Obstrutiva/microbiologia , Células de Kupffer/efeitos dos fármacos , Células de Kupffer/metabolismo , Fígado/efeitos dos fármacos , Fígado/metabolismo , Compostos Orgânicos/farmacologia , Compostos Orgânicos/uso terapêutico , Solução de Ringer , Succinatos/farmacologia , Succinatos/uso terapêuticoRESUMO
This prospective randomized study incorporates 141 surgical department patients with hepatobiliary tumors. The 1st group patients received 800 ml/day of remaxol. The 2nd1 group patients received Ringer solution and 10% glucose at 1:1 ratio. The subgroups included: 1 subgroup-with pre-operative cholecysto- or choledochostomia and B-subgroup-without pre-operative interventions. The combined surgical and pharmaceutical correction of bile passage, bilirubinemia, cholestasis and cytolysis by remaxole leads to better hepatic dysfunction correction and allows better timing of chemotherapy in bile passage tumors.
