MD1155Z - Minimally invasive mathod for treating spontaneous ascites-peritonitis in decompensated liver cirrhosis - Google Patents
Minimally invasive mathod for treating spontaneous ascites-peritonitis in decompensated liver cirrhosis Download PDFInfo
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- MD1155Z MD1155Z MDS20160146A MDS20160146A MD1155Z MD 1155 Z MD1155 Z MD 1155Z MD S20160146 A MDS20160146 A MD S20160146A MD S20160146 A MDS20160146 A MD S20160146A MD 1155 Z MD1155 Z MD 1155Z
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- ascites
- peritonitis
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- liver cirrhosis
- physiological saline
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- 206010003445 Ascites Diseases 0.000 title claims abstract description 14
- 206010034674 peritonitis Diseases 0.000 title claims abstract description 12
- 208000019425 cirrhosis of liver Diseases 0.000 title claims abstract description 8
- 230000002269 spontaneous effect Effects 0.000 title claims abstract description 7
- MYSWGUAQZAJSOK-UHFFFAOYSA-N ciprofloxacin Chemical compound C12=CC(N3CCNCC3)=C(F)C=C2C(=O)C(C(=O)O)=CN1C1CC1 MYSWGUAQZAJSOK-UHFFFAOYSA-N 0.000 claims abstract description 10
- 102000009123 Fibrin Human genes 0.000 claims abstract description 9
- 108010073385 Fibrin Proteins 0.000 claims abstract description 9
- BWGVNKXGVNDBDI-UHFFFAOYSA-N Fibrin monomer Chemical compound CNC(=O)CNC(=O)CN BWGVNKXGVNDBDI-UHFFFAOYSA-N 0.000 claims abstract description 9
- 229950003499 fibrin Drugs 0.000 claims abstract description 9
- 238000011282 treatment Methods 0.000 claims abstract description 8
- QGZKDVFQNNGYKY-UHFFFAOYSA-O Ammonium Chemical compound [NH4+] QGZKDVFQNNGYKY-UHFFFAOYSA-O 0.000 claims abstract description 5
- 108010003272 Hyaluronate lyase Proteins 0.000 claims abstract description 5
- 102000001974 Hyaluronidases Human genes 0.000 claims abstract description 5
- 230000003187 abdominal effect Effects 0.000 claims abstract description 5
- VAAUVRVFOQPIGI-SPQHTLEESA-N ceftriaxone Chemical compound S([C@@H]1[C@@H](C(N1C=1C(O)=O)=O)NC(=O)\C(=N/OC)C=2N=C(N)SC=2)CC=1CSC1=NC(=O)C(=O)NN1C VAAUVRVFOQPIGI-SPQHTLEESA-N 0.000 claims abstract description 5
- 229960003405 ciprofloxacin Drugs 0.000 claims abstract description 5
- UREBDLICKHMUKA-CXSFZGCWSA-N dexamethasone Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)CO)(O)[C@@]1(C)C[C@@H]2O UREBDLICKHMUKA-CXSFZGCWSA-N 0.000 claims abstract description 5
- 229960003957 dexamethasone Drugs 0.000 claims abstract description 5
- 229960002773 hyaluronidase Drugs 0.000 claims abstract description 5
- 239000000203 mixture Substances 0.000 claims abstract description 5
- 238000000034 method Methods 0.000 claims description 12
- 239000002504 physiological saline solution Substances 0.000 claims description 12
- 210000000416 exudates and transudate Anatomy 0.000 claims description 5
- 210000000056 organ Anatomy 0.000 claims description 5
- -1 200 mg twice a day Chemical compound 0.000 claims description 4
- 229960004755 ceftriaxone Drugs 0.000 claims description 4
- 238000002695 general anesthesia Methods 0.000 claims description 4
- 238000002357 laparoscopic surgery Methods 0.000 claims description 4
- 239000000243 solution Substances 0.000 claims description 4
- 239000003814 drug Substances 0.000 abstract description 2
- 210000002966 serum Anatomy 0.000 abstract 3
- 230000003908 liver function Effects 0.000 description 7
- 210000003567 ascitic fluid Anatomy 0.000 description 6
- 238000002604 ultrasonography Methods 0.000 description 4
- 210000000683 abdominal cavity Anatomy 0.000 description 3
- 238000009825 accumulation Methods 0.000 description 3
- 238000001804 debridement Methods 0.000 description 3
- 238000003745 diagnosis Methods 0.000 description 3
- 230000006872 improvement Effects 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- 208000004998 Abdominal Pain Diseases 0.000 description 2
- 206010030302 Oliguria Diseases 0.000 description 2
- 206010037660 Pyrexia Diseases 0.000 description 2
- 239000003242 anti bacterial agent Substances 0.000 description 2
- 229940088710 antibiotic agent Drugs 0.000 description 2
- 230000004054 inflammatory process Effects 0.000 description 2
- 230000035987 intoxication Effects 0.000 description 2
- 231100000566 intoxication Toxicity 0.000 description 2
- 210000004185 liver Anatomy 0.000 description 2
- 239000013049 sediment Substances 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 206010060921 Abdominal abscess Diseases 0.000 description 1
- 206010010075 Coma hepatic Diseases 0.000 description 1
- 206010016654 Fibrosis Diseases 0.000 description 1
- 239000004599 antimicrobial Substances 0.000 description 1
- 230000003115 biocidal effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000007882 cirrhosis Effects 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 230000009089 cytolysis Effects 0.000 description 1
- 230000006837 decompression Effects 0.000 description 1
- 230000010339 dilation Effects 0.000 description 1
- 239000002934 diuretic Substances 0.000 description 1
- 229940030606 diuretics Drugs 0.000 description 1
- 230000000004 hemodynamic effect Effects 0.000 description 1
- 201000001059 hepatic coma Diseases 0.000 description 1
- 208000007386 hepatic encephalopathy Diseases 0.000 description 1
- 230000013632 homeostatic process Effects 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 238000007912 intraperitoneal administration Methods 0.000 description 1
- 238000011835 investigation Methods 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 238000002350 laparotomy Methods 0.000 description 1
- 231100000518 lethal Toxicity 0.000 description 1
- 230000001665 lethal effect Effects 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 210000003200 peritoneal cavity Anatomy 0.000 description 1
- 208000007232 portal hypertension Diseases 0.000 description 1
- 210000003240 portal vein Anatomy 0.000 description 1
- 238000011321 prophylaxis Methods 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 210000000955 splenic vein Anatomy 0.000 description 1
- 239000013589 supplement Substances 0.000 description 1
- 230000001629 suppression Effects 0.000 description 1
- 238000011477 surgical intervention Methods 0.000 description 1
- 208000011580 syndromic disease Diseases 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
- 238000012800 visualization Methods 0.000 description 1
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- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
- Measuring Or Testing Involving Enzymes Or Micro-Organisms (AREA)
Abstract
Invenţia se referă la medicină, în special la hepatologie şi hepatochirurgie, şi poate fi aplicată pentru tratamentul ascit-peritonitei spontane în ciroza hepatică decompensată.Esenţa invenţiei constă în aceea că se efectuează laparoscopia sub anestezie generală, se aspiră lent exsudatul peritoneal, se inspectează organele abdominale şi se debridează plăcile fibrinice, apoi se efectuează lavajul cu 1…2 L de ser fiziologic cu 8…16 mg de dexametazonă, după care soluţia se aspiră, apoi se introduce un amestec, care conţine 370…640 UC de hialuronidază dizolvată în 200…400 ml de ser fiziologic şi 10…50 mg de biclorură de 1,10 decametilen-bis(N,N-dimetil-mentoxicarbonilmetil) amoniu dizolvată în 500…2000 ml de ser fiziologic, concomitent se administrează intravenos ciprofloxacin, 200 mg de 2 ori pe zi, şi ceftriaxon, 2 g de 2 ori pe zi, totodată tratamentul parenteral se repetă timp de 3…5 zile.The invention relates to medicine, in particular to hepatology and hepatosurgery, and can be applied for the treatment of spontaneous ascites-peritonitis in decompensated liver cirrhosis. abdominal and the fibrin plates are debridged, then washed with 1 ... 2 L of physiological serum with 8 ... 16 mg dexamethasone, after which the solution is aspirated, then a mixture containing 370 ... 640 UC of hyaluronidase dissolved in 200 is introduced. ... 400 ml of physiological serum and 10 ... 50 mg of 1.10 decamethylene-bis (N, N-dimethyl-mentoxycarbonylmethyl) ammonium bichloride dissolved in 500 ... 2000 ml of physiological serum, co-administered intravenously with ciprofloxacin, 200 mg of 2 times a day, and ceftriaxon, 2 g 2 times a day, at the same time parenteral treatment is repeated for 3 ... 5 days.
Description
Invenţia se referă la medicină, în special la hepatologie şi hepatochirurgie, şi poate fi aplicată pentru tratamentul ascit-peritonitei spontane în ciroza hepatică decompensată. The invention relates to medicine, in particular to hepatology and hepatosurgery, and can be applied for the treatment of spontaneous ascites-peritonitis in decompensated liver cirrhosis.
Este cunoscută metoda de tratament al ascit-peritonitei prin laparocenteză fracţionară dirijată cu efectuarea lavajului intraabdominal şi administrarea iniţială intraabdominală a antibioticelor de spectru larg, iar după obţinerea antibioticogramei cu efectuarea antibiotocoterapiei ţintite [1]. Totodată, în cazul sindromului ascitic cirogen evoluează o suprimare a proceselor peritoneale rezorbtive cu instalarea unei staze circulatorii, care menţine procesul inflamator peritoneal, ce provoacă în coninuare complicaţii potenţial letale, ca insuficienţa hepato-renală, coma hepatică. The method of treating ascites-peritonitis by directed fractional laparocentesis with intra-abdominal lavage and initial intra-abdominal administration of broad-spectrum antibiotics is known, and after obtaining the antibiogram with targeted antibiotic therapy [1]. At the same time, in the case of surgical ascites syndrome, a suppression of peritoneal resorptive processes develops with the installation of a circulatory stasis, which maintains the peritoneal inflammatory process, which in turn causes potentially lethal complications, such as hepatorenal insufficiency, hepatic coma.
Dezavantajul metodei constă în eficienţă redusă în ce priveşte asanarea cavităţii peritoneale, deoarece accesul este redus, drenarea este insuficienţă din cauza menţinerii unor colecţii restante în regiunile inferioare şi interintestinale, ceea ce poate conduce la formarea unor abcese intraabdominale. The disadvantage of the method is its low efficiency in terms of cleaning the peritoneal cavity, because access is limited, drainage is insufficient due to the maintenance of residual collections in the lower and interintestinal regions, which can lead to the formation of intra-abdominal abscesses.
Problema pe care o rezolvă invenţia constă în elaborarea unei metode complexe miniinvazive laparoscopice cu decompresia, evacuarea totală a exsudatului peritoneal, vizualizarea şi inspecţia completă a organelor intraabdominale, cu debridarea plăcilor fibrinice şi liza fermentativă a lor, pentru o asanare eficientă a cavităţii abdominale cu profilaxia complicaţiilor septice şi a insuficienţei hepato-renale. The problem solved by the invention consists in developing a complex minimally invasive laparoscopic method with decompression, total evacuation of peritoneal exudate, complete visualization and inspection of intra-abdominal organs, with debridement of fibrin plaques and their fermentative lysis, for efficient sanitation of the abdominal cavity with prophylaxis of septic complications and hepatorenal insufficiency.
Esenţa invenţiei constă în aceea că se efectuează laparoscopia sub anestezie generală, se aspiră lent exsudatul peritoneal, se inspectează organele abdominale şi se debridează plăcile fibrinice, apoi se efectuează lavajul cu 1…2 L de ser fiziologic cu 8…16 mg de dexametazonă, după care soluţia se aspiră, apoi se introduce un amestec, care conţine 370…640 UC de hialuronidază dizolvată în 200…400 ml de ser fiziologic şi 10…50 mg de biclorură de 1,10 decametilen-bis(N,N-dimetil-mentoxicarbonilmetil) amoniu dizolvată în 500…2000 ml de ser fiziologic, concomitent se administrează intravenos ciprofloxacin, 200 mg de 2 ori pe zi, şi ceftriaxon, 2 g de 2 ori pe zi, totodată tratamentul parenteral se repetă timp de 3…5 zile. The essence of the invention consists in performing laparoscopy under general anesthesia, slowly aspirating the peritoneal exudate, inspecting the abdominal organs and debriding the fibrin plaques, then performing lavage with 1...2 L of physiological saline with 8...16 mg of dexamethasone, after which the solution is aspirated, then introducing a mixture containing 370...640 CU of hyaluronidase dissolved in 200...400 ml of physiological saline and 10...50 mg of 1,10 decamethylene-bis(N,N-dimethyl-mentoxycarbonylmethyl) ammonium bichloride dissolved in 500...2000 ml of physiological saline, simultaneously administering intravenously ciprofloxacin, 200 mg 2 times a day, and ceftriaxone, 2 g 2 times a day, while parenteral treatment is repeated for 3...5 days.
Rezultatul invenţiei constă în rezolvarea ascit-peritonitei, ameliorarea proceselor de resorbţie peritoneală cu reducerea ulterioară a acumulării lichidului ascitic, micşorarea riscului de recidivare a procesului septic intraabdominal şi ameliorarea funcţiei hepatice. The result of the invention consists in resolving ascites-peritonitis, improving peritoneal resorption processes with subsequent reduction of ascitic fluid accumulation, reducing the risk of recurrence of the intra-abdominal septic process and improving liver function.
Avantajele metodei revendicate constau în: The advantages of the claimed method consist of:
- posedă o eficacitate înaltă în rezolvarea ascit-peritonitei spontane, - has high efficacy in resolving spontaneous ascites-peritonitis,
- reduce rata recidivelor ascit-peritonitei la bolnavul cirotic decompensat, - reduces the rate of recurrence of ascites-peritonitis in decompensated cirrhotic patients,
- nu necesită aparataj costisitor, - does not require expensive equipment,
- micşorează perioada de spitalizare şi reabilitare a acestor pacienţi. - reduces the hospitalization and rehabilitation period of these patients.
Metoda se efectuează în modul următor. După internarea pacientului şi efectuarea investigaţiilor clinice şi paraclinice, şi anume a ultrasonografiei pentru confirmarea diagnosticului, corecţia homeostazei şi stabilizarea hemodinamică, se recurge la metoda revendicată. Se efectuează laparoscopia sub anestezie generală, se aspiră lent exsudatul peritoneal, se inspectează organele abdominale şi se debridează plăcile fibrinice, apoi se efectuează lavajul cu 1…2 L de ser fiziologic cu 8…16 mg de dexametazonă, după care soluţia se aspiră, apoi se introduce un amestec, care conţine 370…640 UC de hialuronidază dizolvată în 200…400 ml de ser fiziologic şi 10…50 mg de biclorură de 1,10 decametilen-bis(N,N-dimetil-mentoxicarbonilmetil) amoniu dizolvată în 500…2000 ml de ser fiziologic, concomitent se administrează intravenos ciprofloxacin, 200 mg de 2 ori pe zi, şi ceftriaxon, 2 g de 2 ori pe zi, totodată tratamentul parenteral se repetă timp de 3…5 zile. The method is performed as follows. After the patient is admitted and clinical and paraclinical investigations are performed, namely ultrasonography to confirm the diagnosis, correct homeostasis and stabilize hemodynamics, the claimed method is used. Laparoscopy is performed under general anesthesia, the peritoneal exudate is slowly aspirated, the abdominal organs are inspected and the fibrin plaques are debridement, then lavage is performed with 1…2 L of physiological saline with 8…16 mg of dexamethasone, after which the solution is aspirated, then a mixture is introduced, containing 370…640 CU of hyaluronidase dissolved in 200…400 ml of physiological saline and 10…50 mg of 1,10 decamethylene-bis(N,N-dimethyl-mentoxycarbonylmethyl) ammonium bichloride dissolved in 500…2000 ml of physiological saline, simultaneously ciprofloxacin, 200 mg 2 times a day, and ceftriaxone, 2 g 2 times a day are administered intravenously, at the same time parenteral treatment is repeated for 3…5 days.
Metoda revendicată a fost aplicată la 16 pacienţi cu ciroză hepatică decompensată complicată cu ascit-peritonită spontană, după care s-a rezolvat procesul inflamator septic intraperitoneal, fără necesitatea efectuării unor intervenţii chirurgicale traumatice (laparotomie) de sanare a cavităţii abdominale. The claimed method was applied to 16 patients with decompensated liver cirrhosis complicated by spontaneous ascites-peritonitis, after which the intraperitoneal septic inflammatory process was resolved, without the need for traumatic surgical interventions (laparotomy) to repair the abdominal cavity.
Exemplul 1 Example 1
Pacienta P., 53 ani, a fost internată în secţia chirurgie cu diagnosticul de ciroză hepatică decompensată complicată cu ascit-peritonită. Pe parcursul a 6 luni antecedent s-au efectuat laparocenteze de volum repetate la 2…3 săptămâni cu evacuarea în medie a 7…8 L de lichid ascitic, iniţial transparent, apoi tulbure cu sediment de fibrină, concomitent agravându-se starea generală prin dureri abdominale difuze, frisoane cu febră intermitentă, progresarea intoxicaţiei endogene, oligurie, decompensarea funcţiei hepatice. Examenul ultrasonografic la internare denotă ficat cu contur neregulat, macronodular şi semne ecografice de hipertensiune portală (dilatarea v.porte - 16 mm şi v. splenice - 10mm). În cavitatea abdominală o cantitate mare de lichid asitic neomogen cu elemente flotante, incluziuni hiperecogene şi fibrină - semne ecografice caracteristice ascit-peritonitei spontane cirogene. Patient P., 53 years old, was admitted to the surgery department with the diagnosis of decompensated liver cirrhosis complicated by ascites-peritonitis. During the previous 6 months, repeated volume laparocentesis was performed every 2…3 weeks with the evacuation of an average of 7…8 L of ascitic fluid, initially transparent, then cloudy with fibrin sediment, concomitantly worsening general condition with diffuse abdominal pain, chills with intermittent fever, progression of endogenous intoxication, oliguria, decompensation of liver function. Ultrasound examination upon admission shows a liver with irregular, macronodular contour and ultrasound signs of portal hypertension (dilation of the portal vein - 16 mm and splenic vein - 10 mm). In the abdominal cavity a large amount of inhomogeneous ascitic fluid with floating elements, hyperechoic inclusions and fibrin - ultrasound signs characteristic of spontaneous surgical ascites-peritonitis.
Pe fondal de tratament conservativ cu hepatoprotectoare, diuretice, antimicrobiene, antibiotice etc. s-a obţinut ameliorarea statutului hepatic funcţional şi s-a recurs la metoda revendicată. Against the background of conservative treatment with hepatoprotectors, diuretics, antimicrobials, antibiotics, etc., improvement in the functional liver status was achieved and the claimed method was used.
Controlul dinamic clinic şi paraclinic a relevat ameliorarea stării generale a pacientului cu îmbunătăţirea funcţiilor hepatice, micşorarea acumulării lichidului ascitic fără elemente flotante, transparent, ce a permis externarea lui la a 9-a zi de spitalizare în stare relativ satisfăcătoare cu funcţie hepatică stabilizată. Dynamic clinical and paraclinical control revealed an improvement in the patient's general condition with improved liver function, a decrease in the accumulation of ascitic fluid without floating elements, transparent, which allowed his discharge on the 9th day of hospitalization in a relatively satisfactory condition with stabilized liver function.
Exemplul 2 Example 2
Pacientul K., 64 ani, a fost internat în secţia chirurgie cu diagnosticul de ciroză hepatică decompensată complicată cu ascit-peritonită. Pe parcursul a 5 luni antecedent s-au efectuat laparocenteze de volum repetate la 3 săptămâni cu evacuarea în medie a 7…8 L de lichid ascitic, iniţial transparent, apoi tulbure cu sediment de fibrină, concomitent agravându-se starea generală prin dureri abdominale difuze, frisoane cu febră intermitentă, progresarea intoxicaţiei endogene, oligurie, decompensarea funcţiei hepatice. S-a efectuat laparoscopia sub anestezie generală, s-a aspirat lent exsudatul peritoneal, s-au inspectat organele abdominale şi s-au debridat plăcile fibrinice, apoi s-a efectuat lavajul cu 2 L de ser fiziologic cu 16 mg de dexametazonă, după care soluţia s-a aspirat, apoi s-a introdus un amestec, care conţine 640 UC de hialuronidază dizolvată în 400 ml de ser fiziologic şi 40 mg de biclorură de 1,10 decametilen-bis(N,N-dimetil-mentoxicarbonilmetil) amoniu dizolvată în 1500 ml de ser fiziologic, concomitent s-a administrat intravenos ciprofloxacin, 200 mg de 2 ori pe zi, şi ceftriaxon, 2 g de 2 ori pe zi, iar tratamentul parenteral s-a repetat 5 zile. Patient K., 64 years old, was admitted to the surgery department with a diagnosis of decompensated liver cirrhosis complicated by ascites-peritonitis. During the previous 5 months, repeated volume laparocentesis was performed every 3 weeks with the evacuation of an average of 7…8 L of ascitic fluid, initially transparent, then cloudy with fibrin sediment, concomitantly worsening general condition with diffuse abdominal pain, chills with intermittent fever, progression of endogenous intoxication, oliguria, decompensation of liver function. Laparoscopy was performed under general anesthesia, the peritoneal exudate was slowly aspirated, the abdominal organs were inspected and the fibrin plaques were debridement, then lavage was performed with 2 L of physiological saline with 16 mg of dexamethasone, after which the solution was aspirated, then a mixture was introduced, containing 640 CU of hyaluronidase dissolved in 400 ml of physiological saline and 40 mg of 1,10 decamethylene-bis(N,N-dimethyl-mentoxycarbonylmethyl) ammonium bichloride dissolved in 1500 ml of physiological saline, simultaneously ciprofloxacin, 200 mg twice a day, and ceftriaxone, 2 g twice a day, were administered intravenously, and parenteral treatment was repeated for 5 days.
Controlul dinamic clinic şi paraclinic a relevat ameliorarea stării generale a pacientului cu îmbunătăţirea funcţiilor hepatice, micşorarea acumulării lichidului ascitic fără elemente flotante, transparent, ce a permis externarea lui la a 9-a zi de spitalizare în stare relativ satisfăcătoare cu funcţie hepatică stabilizată. Dynamic clinical and paraclinical control revealed an improvement in the patient's general condition with improved liver function, a decrease in the accumulation of ascitic fluid without floating elements, transparent, which allowed his discharge on the 9th day of hospitalization in a relatively satisfactory condition with stabilized liver function.
1. Moore K., Aithal G. Guidelines on the management of ascites in cirrhosis. Gut, 2006, vol. 55, (Suppliment 6), p. 1-12 1. Moore K., Aithal G. Guidelines on the management of ascites in cirrhosis. Gut, 2006, vol. 55, (Supplement 6), p. 1-12
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| MD1204Z (en) * | 2017-06-08 | 2018-05-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Laparoscopic method for treating refractory ascites in decompensated liver cirrhosis |
Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SU1678335A1 (en) * | 1989-12-26 | 1991-09-23 | Центральный научно-исследовательский рентгенорадиологический институт | Method for therapy of lymphostasis in cases of hepatic cirrohosis |
| MD774F2 (en) * | 1995-07-12 | 1997-07-31 | Inst De Microbiologie Al Acade | Method of sewage treatment from uranil ions |
| MD926G2 (en) * | 1997-05-23 | 1998-07-31 | Firma Interramurala De Productie Si Comert "Gum" Srl | Mixture for roofing and water proofing material manufacturing |
| MD927G2 (en) * | 1996-04-09 | 1998-12-31 | Государственный аграрный университет Молдовы | Cold accumulator |
| MD3444G2 (en) * | 2007-05-17 | 2008-07-31 | Борис ПЫРГАРЬ | Method of treating the spontaneous bacterial peritonitis in the decompensated hepatic cirrhosis with resistant ascitic syndrome |
| MD398Y (en) * | 2010-11-30 | 2011-07-31 | Gheorghe Anghelici | Method for stimulating the resorption of peritoneal processes by reactivation of lymphocirculation in patients with hepatic cirrhosis |
-
2016
- 2016-12-08 MD MDS20160146A patent/MD1155Z/en not_active IP Right Cessation
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SU1678335A1 (en) * | 1989-12-26 | 1991-09-23 | Центральный научно-исследовательский рентгенорадиологический институт | Method for therapy of lymphostasis in cases of hepatic cirrohosis |
| MD774F2 (en) * | 1995-07-12 | 1997-07-31 | Inst De Microbiologie Al Acade | Method of sewage treatment from uranil ions |
| MD927G2 (en) * | 1996-04-09 | 1998-12-31 | Государственный аграрный университет Молдовы | Cold accumulator |
| MD926G2 (en) * | 1997-05-23 | 1998-07-31 | Firma Interramurala De Productie Si Comert "Gum" Srl | Mixture for roofing and water proofing material manufacturing |
| MD3444G2 (en) * | 2007-05-17 | 2008-07-31 | Борис ПЫРГАРЬ | Method of treating the spontaneous bacterial peritonitis in the decompensated hepatic cirrhosis with resistant ascitic syndrome |
| MD398Y (en) * | 2010-11-30 | 2011-07-31 | Gheorghe Anghelici | Method for stimulating the resorption of peritoneal processes by reactivation of lymphocirculation in patients with hepatic cirrhosis |
Non-Patent Citations (1)
| Title |
|---|
| Moore K., Aithal G. Guidelines on the management of ascites in cirrhosis. Gut, 2006, vol. 55, (Suppliment 6), p. 1-12 * |
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| Publication number | Publication date |
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| MD1155Y (en) | 2017-06-30 |
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