Year 2015 Vol. 23 No 4




SBEE HPE "I.M. Sechenov First Moscow State Medical University",
The Russian Federation

Objectives. To study the effectiveness of local application of ozonated physiological solution on the bacterial microflora of the biliary tract in patients with obstructive jaundice.
Methods. The drainage of the biliary tract by retrograde or antegrade method was performed to patients with complicated jaundice (different degrees) under sonographic and fluoroscopic guidance. The intake of bile through the fixed biliary drainage (nasobiliary drainage, percutaneous transhepatic cholangiostomy (PTCS) was carried out for inoculation on the medium immediately after drainage of the biliary tract as well as to control bacteriological sowing of bile on the third and seventh days. This study was performed to determine the spectrum of bacterial flora of the biliary tract and to control the conducted local therapy with physiological solution with ozone at concentration of 5 mg/L, saline (1000 ml.) are to be done daily .
Results. On the third day after drainage of the bile ducts (BD) the bacteriological composition has been changed. The incidence of detection of Klebsiella spp. significantly reduces from 21 cases to 6 and Escherichia coli from 22 to 10 cases. The number of Pseudomona aeruginosa increases from 8 to 18 cases and Enterococcus spp – from 6 to 24 cases. The titre of microbial bodies Enterococcus spp raises from 3,77 to 4,86±0,12 of colony forming units (CFU)/ml. Daily sanitation (5 mg/l, (1000 ml) of BD with ozonated physiological solution promotes to reduce all types of microorganisms with a realiable reduction detection incidence of Pseudomona aeruginosa and Enterococcus spp up to 6 cases and a decrease of the titre of microbial cells up to 4,1±0,17 and 3,2±0,58, respectively.
Conclusion. In the hospital the number of conditionally pathogenic microflora has reduced reliably and the number of nosocomial infections increased. The conducted study has confirmed the efficacy of ozonated physiological solution for the prevention and treatment of infectious complications in patients with cholestasis.

Keywords: obstructive jaundice, ozonated physiological solution, biliary drainage, percutaneous transhepatic cholangiostomy, nosocomial infection, conditionally pathogenic microflora, cholestasis
p. 379-384 of the original issue
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Address for correspondence:
109240, Russian Federation,
Moscow, ul. Yauzskaya d. 11. str. 1,
GKB im. I.V. Davyidovskogo,
GBOU VPO "Pervyiy moskovskiy
gosudarstvennyiy meditsinskiy universitet
imeni I.M. Sechenova",
kafedra obschey khirurgii,
Kurmanbaev Azamat Gultashyirovich
Information about the authors:
Struchkov Y.V. MD, professor, a senior researcher of the general surgery chair of SBEE HPE "I.M. Sechenov First Moscow State Medical University".
Vorotyncev A.S. PhD, an associate professor of the general surgery chair of SBEE HPE "I.M. Sechenov First Moscow State Medical University".
Kurmanbaev A.G. A post-graduate student of the general surgery chair of SBEE HPE "I.M. Sechenov First Moscow State Medical University".
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