Year 2015 Vol. 23 No 3




SBEE HPE "Rostov State Medical University"
The Russian Federation

Objectives. Comparative estimation of the clinical efficiency of traditional intravenous (intracaval) and intraportal infusion therapy (IPIT) in correction of functional liver failure and endotoxicosis (ET) in generalized peritonitis (GP).
Methods. The patients with GP (n=324) manifesting abdominal sepsis and ET had been enrolled in the study and divided into 2 groups according to the principle approach to treatment. In the first group (n=175) the patients were traditionally treated with intracaval infusion therapy according to the conventional standards. In the second group (n=167), redrainage and catheterization of the umbilical vein were performed intraoperatively and further combined with a standard therapy IPIT was applied. In the comparative aspect the laboratory indicators of the liver functional status and endotoxicosis had been investigated, including the severity of the systematic inflammatory reaction (SIR) as well as the immediate treatment results of both groups.
Results. In the second group, on the IPIT background in the early stages the leukocytosis, concentration of C-reactive protein, fibrinogen, general bilirubin, concentration of cytolysis markers of hepatocytes, laboratory indicators of ET (urea, creatinine, myoglobin, Leukocyte Index of Intoxication and Average Molecular Peptide) were reduced as well as a distinct increase of general protein and albumins in comparison with the analogical values was registered in the first group of patients. The complication rate (the average) in the main group was lower by 9,1% and the postoperative mortality – 8,2% compared with the control group.
Conclusion. In the early postoperative period using IPIT in patients with GP promotes the rehabilitation of the functional liver failure and significantly reduces the severity of ET allowing improving the immediate treatment Results.

Keywords: generalized peritonitis, liver insufficiency, endotoxicosis, intraportal infusions, rehabilitation, complications, postoperative mortality
p. 296-301 of the original issue
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Address for correspondence:
344010, Rossiyskaya Federatsiya,
g. Rostov-na-Donu, pr. Voroshilovskiy, d. 105,
GBOU VPO "Rostovskiy gosudarstvennyiy meditsinskiy universitet,"
kafedra obschey khirurgii,
tel. mob. 7 903 406-00-97,
Efanov Sergey Yurevich
Information about the authors:
Belik B.M. MD, a head of the general surgery chair of SBEE HPE "Rostov State Medical University".
Efanov S.U. PhD, an assistant of the general surgery chair of SBEE HPE "Rostov State Medical University"
Maslov A.I. PhD, an associate professor of the general surgery chair of SBEE HPE "Rostov State Medical University."
Suyarko V.A. A post-graduate student of the general surgery chair of SBEE HPE "Rostov State Medical University".
Sapraliev A.R. A senior laboratory assistant of the general surgery chair of SBEE HPE "Rostov State Medical University".
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