Novosti
Khirurgii

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Year 2015 Vol. 23 No 1

GENERAL AND SPECIAL SURGERY

E.A. MATUSEVICH

METABOLIC CORRECTION OF T CELL-MEDIATED IMMUNITY AND ENDOGENOUS INTOXICATION IN GENERALIZED PURULENT PERITONITIS

HI "Braslav Central Regional Hospital",
EE "Vitebsk State Medical University",
The Republic of Belarus

Objectives. To assess changes of the immunogram indicators, integral hematologic indices of endogenous intoxication, mortality rate, the number of postoperative complications in patients with generalized purulent peritonitis and possibilities of their correction by Cytoflavin, a drug which contains succinic acid.
Methods. The treatment analysis of 158 patients with generalized purulent peritonitis has been carried out; the patients were classified into 2 groups: the control group (106 patients treated with traditional and complex therapy) and the main group (52 patients receiving additionally Cytoflavin). The effect of Cytoflavin on the main parameters of T cell-mediated immunity, dynamics of integral hematologic indices of endogenous intoxication, mortality rate and the number of postoperative complications in case of the given pathology has been studied.
Results. In the postoperative period in patients with generalized purulent peritonitis the significant changes in immunogram parameters characterized by the increase of the number of active T-lymphocytes, the reduction of general T- lymphocytes, T-helper lymphocytes, the immunoregulatory index, indices of stimulated NBT test of leukocytes with simultaneous increase of NBT-spontaneous test and the reduced phagocytic index test have been registered. The elevated main hematologic indices of the endogenous intoxication and the increase in the number of absolute leukocytes count have been noticed. On the 7-10th days the changes were persisted in the case of the traditional treatment. In the group of patients where Cytoflavin was applied, the studied indices were considered to be similar to normal or were not statistically differed from those. The mortality was reduced from 19,81% up to 11,54%, and the number of postoperative complications – from 16,98% up to 13,46% (in 1,72 and 1,26, respectively) in the main group compared with the control one.
Conclusion. The inclusion of Cytoflavin, a drug which contains succinic acid, in the complex treatment of patients with generalized purulent peritonitis contributes to the normalization of cellular immune parameters, as well as the reduction of the leukocytosis and endotoxicosis severity within the early postoperative period, the decrerase of the mortality rate and quantity of postoperative complications indicates for the possibility of Cytoflavin application as a metabolic immunocorrector.

Keywords: generalized purulent peritonitis, T cell-mediated immunity, endogenous intoxication, treatment, metabolic correction, Cytoflavin
p. 77-84 of the original issue
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Address for correspondence:
211970, Respublika Belarus',
Vitebskaia oblast', g. Braslav,
ul. Sovetskaia, d. 138,
UZ "Braslavskaia TsRB",
tel. mob: +375 29 714-19-10,
e-mail: Burat@km.ru,
Matusevich Evgenii Anatol'evich
Information about the authors:
Matusevich EA, a deputy chief physician (medicine) of HI "Braslav CRH", a competitor of the department of hospital surgery with courses of urology and pediatric surgery EE "Vitebsk State Medical University."
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