THE RELATIONSHIP OF THE IMMUNE AND METABOLIC DISORDERS DURING VARIOUS METHODS OF MULTICOMPONENT GENERAL ANESTHESIA IN LAPAROSCOPIC CHOLECYSTECTOMY.

BACKGROUND: In addition to operating injury in the pathogenesis of immunological and metabolic disorders after surgical interventions anesthesia plays an important role. THE AIM: to establish the relationship of the immune and metabolic disorders during various methods ofmulticomponent general anesthesia in conditions of laparoscopic cholecystectomy in patients with cholelithiasis. MATERIALS AND METHODS: Under constant observation there were 68 women admitted to the hospital for surgical treatment of cholelithiasis. Patients were divided into 3 groups depending on multicomponent general anesthesia (halothane, propofol, sevoflurane). We determined the concentration of cytokines (TNFa, IL-la, IL-i/8, IL-4, IL-iRA, IL-2, IFNy), components of the complement system (C,, C3, C4, C, and C, factor H, C,-inhibitor), the activity of neutrophilsperipheral blood, the concentration of the products ofperoxidation, catalase, superoxide dismutase in blood plasma. RESULTS: The level of immune-inflammation and metabolic disorders in patients with cholelithiasis was higher in patients operated with the use of halothane. The use of sevoflurane has had the most positive effect on the studied indices. CONCLUSION: The close correlation between the investigated immune and metabolic parameters on the background of the use of different schemes of multicomponent general anesthesia in patients with cholelithiasis have let to the conclusion that in the conditions of use of sevoflurane has the least place a "tension" immune and oxidative status.

[STRUCTURAL AND FUNCTIONAL PROPERTIES OF ERYTHROCYTES WHEN USING VARIOUS METHODS OF MULTICOMPONENT GENERAL ANESTHESIA AT LAPAROSCOPIC HOLETSISTEKTOMY AT PATIENTS WITH CHOLELITHIASIS.]

At patients with the verfied diagnosis have a cholelithiasis, transferred a laparoscopic holetsistektomy against the combined general anesthesia with muscle relaxants and artificial lung ventilation with use ofvarious anesthetics, the intraerythrocyte intensifi- cation of processes of peroxidation of lipids is established, and in a membrane of erythrocytes essential change of the contents and a ratio of the proteins and lipids responsible for structure, stabilization of a membrane and function of erythrocytes is revealed. Application of a sevoflurane, in comparison with propofol and, especially, a halothane, to a lesser extent influences structurally functional properties of erythrocytes that demands profile development ofpharmacological correction of the revealed violations.

[Blood rheological characteristics of uteroplacental blood flow in severe gestosis].

OBJECTIVE: To investigate the clinical and morphological features of uteroplacental blood flow during pregnancy in severe gestosis. SUBJECTS AND METHODS: One hundred and twenty-five patients with severe gestosis were examined. Scanning probe and electron microscopy with macro- and microelement analysis and transmission microscopy were used to study their placentas, umbilical cords, endometrium, myometrium, and maternal blood in severe gestosis. RESULTS: It is shown that circulatory disorders in the structural components of the examined tissues and organs, as well as changes in cytoarchitectonics and red blood cell functional properties may be a component of the trigger of disseminated intravascular coagulation, followed by impaired maternal and fetal vital activity. CONCLUSION: The investigation of the pathomorphological features of the microcirculatory bed in the mother-placenta-fetus system in gestosis has shown that possible methods of their correction should be further sought.

[Economic effectiveness of extracorporeal methods of treating surgical patients]. / Ekonomicheskaia éffektivnost' ékstrakorporal'nykh metodov lecheniia khirurgicheskikh bol'nykh.

On the basis of the analysis of the results of treatment of 125 patients of the surgical profile, who were at critical state because of acute renal and hepatic failure, the high cost effectiveness of the extracorporeal methods of detoxication is shown.

[Evaluation of the therapeutic action of hexosephosphate as an energy-supplying agent in acute coronary insufficiency]. / Otsenka lechebnogo deistviia geksozofosfata kak énergoobespechivaiushchego sredstva pri ostroi koronarnoi nedostatochnosti.

It was established in experiments on 24 dogs with ligated interventricular branch of the left coronary artery that hexosophosphate (0.5 and 1 ml/kg intravenously) increases the collateral coronary blood flow and myocardial contractility against the background of a decrease in the lactate content in blood draining from the ischemic zone. Preliminary injection of hexosophosphate to rabbits increases the respiratory control in mitochondria from the ischemic myocardium. Drip intravenous hexosophosphate (100 ml) infusion to patients in the acute period of myocardial infarction reduced significantly sigma ST in precardiac leads and reduced the lactic acid content in venous blood. In 7.6% of cases hexosophosphate caused arrest or abatement of the pain syndrome.