MD520Z - Method for postoperative treatment of patients with nephrolithiasis - Google Patents

Method for postoperative treatment of patients with nephrolithiasis Download PDF

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MD520Z
MD520Z MDS20110192A MDS20110192A MD520Z MD 520 Z MD520 Z MD 520Z MD S20110192 A MDS20110192 A MD S20110192A MD S20110192 A MDS20110192 A MD S20110192A MD 520 Z MD520 Z MD 520Z
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Эмиль ЧЕБАН
Валериу РУДИК
Павел БАНОВ
Andrei Galescu
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Эмиль ЧЕБАН
Валериу РУДИК
Павел БАНОВ
ГАЛЕСКУ Андрей
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Abstract

Изобретение относится к медицине, в частности к урологии и может быть использовано для постоперационного лечения пациентов с почечнокаменной болезнью.Согласно изобретению, заявленный метод включает применение антибиотиков, спазмолитических средств, антиоксидантов, дезинтоксикационную и фитотерапию, при этом с первого послеоперационного дня, дополнительно, внутримышечно вводят экстракт из биомассы штамма цианобактерии Spirulina platensis CNM - CB-02 в концентрации 0,5% - 1,0 мл, одновременно подкожно вводят эноксапарин натрия 2000 МЕ анти-Ха - 0,2 мл, в течение 10-и дней, после чего применяют экстракт из биомассы штамма цианобактерии Spirulina Platensis CNM - CB-02, по одной капсуле 5 мг, два раза в день, в течение 20-и дней.The invention relates to medicine, in particular to urology and can be used for postoperative treatment of patients with kidney stones. According to the invention, the claimed method involves the use of antibiotics, antispasmodics, antioxidants, detoxification and herbal medicine, while from the first postoperative day, additionally, intramuscularly administered extract from the biomass of the strain of cyanobacteria Spirulina platensis CNM - CB-02 at a concentration of 0.5% - 1.0 ml, at the same time enoxaparin sodium 2000 IU anti-Xa - 0.2 ml is injected subcutaneously, in those ix 10 days, after which the extract from the biomass used cyanobacterium strain Spirulina Platensis CNM - CB-02, one capsule 5 mg twice a day for 20-days.

Description

Invenţia se referă la medicină, în special la urologie şi poate fi utilizată pentru tratamentul postoperator al pacienţilor cu litiază renală. The invention relates to medicine, in particular to urology and can be used for the postoperative treatment of patients with renal lithiasis.

Este cunoscută metoda de tratament postoperator al pacienţilor cu litiază renală, care constă în aceea că după înlăturarea calculilor din rinichi, pacienţilor li se administrează: ampicilină 2,0 g de 3…4 ori/zi sau cefazolină 1,0 g de 4 ori/zi, sau amoxicilină 1,0 g de 4 ori/zi, sau ceftriaxonă 1,0 g de 2 ori/zi, sau ceftazidim 1,0 g de 2 ori/zi şi ciprofloxacină 200 mg dizolvate în 200 ml de sol. clorură de sodiu 0,9% sau amikacină 0,25 mg - 10 ml de 3 ori/zi. Concomitent se indică terapia de dezintoxicare: sol. clorură sodiu 0,9% - 200 sau 500 ml; sol. glucoză 5% - 200 sau 500 ml şi de 40% - 10 sau 20 ml; medicaţia antispastică: drotaverină - comprimate câte 40 sau 80 mg şi sol. 2% - 2 ml; platifilină sol. 0,2% - 1 ml; medicaţia antioxidantă: acid ascorbic - comprimate câte 0,5 mg şi sol. 5% - 5 ml intravenos; tocoferol acetat în capsule câte 400 UI şi medicaţia fitoterapeutică pentru tratarea infecţiei tractului urinar: cystone; silingtong; kanefron H; ceai renal; fitolizină; cystenal [1]. The method of postoperative treatment of patients with renal lithiasis is known, which consists in the fact that after removing the kidney stones, patients are administered: ampicillin 2.0 g 3…4 times/day or cefazolin 1.0 g 4 times/day, or amoxicillin 1.0 g 4 times/day, or ceftriaxone 1.0 g 2 times/day, or ceftazidime 1.0 g 2 times/day and ciprofloxacin 200 mg dissolved in 200 ml of 0.9% sodium chloride solution or amikacin 0.25 mg - 10 ml 3 times/day. At the same time, detoxification therapy is indicated: 0.9% sodium chloride solution - 200 or 500 ml; 5% glucose solution - 200 or 500 ml and 40% - 10 or 20 ml; antispastic medication: drotaverine - tablets of 40 or 80 mg and sol. 2% - 2 ml; platifillin sol. 0.2% - 1 ml; antioxidant medication: ascorbic acid - tablets of 0.5 mg and sol. 5% - 5 ml intravenously; tocopherol acetate in capsules of 400 IU and phytotherapeutic medication for treating urinary tract infection: cystone; silingtong; kanefron H; kidney tea; phytolysin; cystenal [1].

Dezavantajul acestei metode constă în aceea că litiaza renală este în permanentă asociere cu pielonefrita cronică calculoasă şi infecţia urinară cronică, de aceea se poate complica cu schimbări sclerotice şi atrofice în ţesutul renal. În acest context, orice intervenţie chirurgicală pe asemenea rinichi poate cauza scăderea semnificativă a funcţiei rinichiului operat. Nefrolitotomia reprezintă o operaţie foarte traumatică care este însoţită de ischemia acută a rinichiului, cu dereglarea microcirculaţiei. The disadvantage of this method is that renal lithiasis is in permanent association with chronic calculous pyelonephritis and chronic urinary tract infection, therefore it can be complicated by sclerotic and atrophic changes in the renal tissue. In this context, any surgical intervention on such kidneys can cause a significant decrease in the function of the operated kidney. Nephrolithotomy is a very traumatic operation that is accompanied by acute ischemia of the kidney, with microcirculation disorders.

Problema pe care o rezolvă invenţia propusă constă în optimizarea tratamentului, îmbunătăţirea funcţiei rinichiului operat, micşorarea perioadei de reconvalescenţă şi a duratei tratamentului postoperator, descreşterea ratei invalidităţii a pacienţilor operaţi cu litiază renală. The problem solved by the proposed invention consists in optimizing the treatment, improving the function of the operated kidney, reducing the recovery period and the duration of postoperative treatment, and decreasing the disability rate of patients operated on for renal lithiasis.

Conform invenţiei, metoda revendicată include administrarea antibioticelor, remediilor antispastice, antioxidante, terapia de dezintoxicare şi fitoterapia, totodată din prima zi după operaţie, suplimentar, intramuscular, se administrează extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 în concentraţie de 0,5% - 1,0 ml, concomitent subcutanat se administrează enoxaparină sodică 2000 UI anti-Xa - 0,2 ml, timp de 10 zile, după care se administrează extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02, câte o capsulă de 5 mg, de două ori pe zi, timp de 20 zile. According to the invention, the claimed method includes the administration of antibiotics, antispasmodic remedies, antioxidants, detoxification therapy and phytotherapy, also from the first day after the operation, additionally, intramuscularly, extract from the biomass of the cyanobacteria strain Spirulina platensis CNM - CB - 02 is administered in a concentration of 0.5% - 1.0 ml, simultaneously subcutaneously enoxaparin sodium 2000 IU anti-Xa - 0.2 ml, for 10 days, after which extract from the biomass of the cyanobacteria strain Spirulina platensis CNM - CB - 02 is administered, one capsule of 5 mg, twice a day, for 20 days.

Datorită administrării extractului din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 în combinaţie cu enoxaparina sodică 2000 UI anti-Xa - 0,2 ml se produce un efect sinergic de potenţare a acţiunii regeneratoare a extractului din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 şi se manifestă un tropism sporit faţă de ţesutul renal. Rezultatele constau în faptul că administrarea combinaţiei de remedii sus-menţionate conform schemei revendicate contribuie la îmbunătăţirea parametrilor funcţiei rinichiului operat, şi anume: clearance-ul ureei şi creatininei, filtraţiei glomerulare şi reabsorbţiei tubulare, precum şi la scăderea perioadei de reconvalescenţă, diminuarea proceselor sclerotice în parenchimul rinichiului operat. De asemenea metoda de tratament propusă permite scăderea ratei recidivelor infecţiei tractului urinar. Pentru prima dată a fost stabilit că extractul din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 de 0,5% - 1 ml şi enoxaparina sodică 2000 UI anti-Xa - 0,2 ml, administrate i/m postoperator timp de 10 zile, au efecte nemijlocite asupra ţesutului renal şi a nefronilor. Asocierea terapiei standarde cu extractul din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 de 0,5% - 1 ml şi enoxaparina sodică 2000 UI anti-Xa - 0,2 ml, administrate după schema nominalizată, a permis diminuarea proceselor sclerotice în parenchimul rinichiului operat de 2 ori faţă de schema standard, a favorizat restabilirea completă a funcţiei renale, a contribuit la creşterea imunităţii pacienţilor, ceea ce a dus la descreşterea ratei infecţiei cronice calculoase cu diminuarea complicaţiilor septice în perioada postoperatorie de 3 ori faţă de rezultatele obţinute la pacienţii din grupele standard. A fost remarcată apariţia mai timpurie a urinei din rinichiul operat în medie cu 1,5 zile, prin nefrostoma instalată intraoperator. Due to the administration of the extract from the biomass of the cyanobacterium strain Spirulina platensis CNM - CB - 02 in combination with sodium enoxaparin 2000 IU anti-Xa - 0.2 ml, a synergistic effect of potentiation of the regenerative action of the extract from the biomass of the cyanobacterium strain Spirulina platensis CNM - CB - 02 is produced and an increased tropism towards the renal tissue is manifested. The results consist in the fact that the administration of the combination of the above-mentioned remedies according to the claimed scheme contributes to the improvement of the parameters of the function of the operated kidney, namely: urea and creatinine clearance, glomerular filtration and tubular reabsorption, as well as to the decrease of the convalescence period, the diminution of sclerotic processes in the parenchyma of the operated kidney. Also, the proposed treatment method allows to decrease the rate of recurrences of urinary tract infection. For the first time, it was established that the extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02 of 0.5% - 1 ml and enoxaparin sodium 2000 IU anti-Xa - 0.2 ml, administered i/m postoperatively for 10 days, have direct effects on renal tissue and nephrons. The combination of standard therapy with the extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02 of 0.5% - 1 ml and enoxaparin sodium 2000 IU anti-Xa - 0.2 ml, administered according to the nominated scheme, allowed the reduction of sclerotic processes in the parenchyma of the operated kidney by 2 times compared to the standard scheme, favored the complete restoration of renal function, contributed to the increase of the patients' immunity, which led to the decrease of the rate of chronic calculous infection with the decrease of septic complications in the postoperative period by 3 times compared to the results obtained in patients from the standard groups. The earlier appearance of urine from the operated kidney by an average of 1.5 days was noted, through the nephrostomy installed intraoperatively.

Au fost efectuate multiple testări clinice cu privire la administrarea extractului din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 de 0,5% - 1 ml i/m şi a enoxaparinei sodice 2000 UI anti-Xa - 0,2 ml pentru a monitoriza starea pacienţilor cu urolitiază după operaţie. Multiple clinical trials have been conducted on the administration of the extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02 of 0.5% - 1 ml i/m and enoxaparin sodium 2000 IU anti-Xa - 0.2 ml to monitor the condition of patients with urolithiasis after surgery.

La un lot de pacienţi tratamentul de bază a fost suplimentat cu extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 în perioada preoperatorie, însă s-a observat că din cauza îmbunătăţirii microcirculaţiei şi activării procesului inflamator în rinichi au apărut dificultăţi tehnice în timpul intervenţiei chirurgicale. De asemenea a crescut riscul complicaţiilor hemoragice din rinichiul operat. In a group of patients, the basic treatment was supplemented with an extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02 in the preoperative period, but it was observed that due to the improvement of microcirculation and the activation of the inflammatory process in the kidney, technical difficulties arose during the surgical intervention. The risk of hemorrhagic complications in the operated kidney also increased.

Au fost analizate rezultatele tratamentului postoperator al pacienţilor, care au fost trataţi conform schemei de bază (34 pacienţi), când la schema de bază s-a adăugat extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 postoperator (3 pacienţi) şi conform metodei revendicate (26 pacienţi). Rezultatele obţinute sunt prezentate în tabel. The results of postoperative treatment of patients who were treated according to the basic scheme (34 patients), when extract from the biomass of the cyanobacterium strain Spirulina platensis CNM - CB - 02 was added to the basic scheme postoperatively (3 patients) and according to the claimed method (26 patients) were analyzed. The results obtained are presented in the table.

Tabel Table

Indici Tratament postoperator conform schemei de bază (n=34) Tratament de bază suplimentat cu extract din biomasa tulpinii cianobacteriei Spirulina platensis postoperator (n=3) Tratament de bază suplimentat cu extract din biomasa tulpinii cianobacteriei Spirulina platensis în combinaţie cu enoxaparină sodică 2000 UI anti-Xa postoperator (n=26) Apariţia substanţei de contrast la urografia i/v pe partea operată (min) La o lună p/o După 6 luni 30-40 20-25 40-60 20-30 20-30 10-12 Micşorarea parenchimului renal (USG, urografia i/v, TC) (% cazuri) 20,6 33,3 10,33 Apariţia urinei pe nefrostomă (zile) 4-5 5-6 3-4 RRI/Scintigrafia Scăderea evidentă a secreţiei în rinichiul operat comparativ cu contralateral După o lună p/o (% cazuri) 29,4 66,6 10,33 Dimensiunile rinichiului operat la USG a o lună p/o Lungimea (cm) Lăţimea (cm) Parenchim (cm) 8,2±0,78 3,6±0,57 1,4±0,22 6,9±0,9 3,5±0,3 1,3±0,3 10,4±0,82 4,4±0,62 1,6±0,3Indices Postoperative treatment according to the basic scheme (n=34) Basic treatment supplemented with extract from the biomass of the cyanobacteria strain Spirulina platensis postoperatively (n=3) Basic treatment supplemented with extract from the biomass of the cyanobacteria strain Spirulina platensis in combination with enoxaparin sodium 2000 IU anti-Xa postoperatively (n=26) Appearance of contrast material on i/v urography on the operated side (min) One month p/o After 6 months 30-40 20-25 40-60 20-30 20-30 10-12 Shrinkage of the renal parenchyma (USG, i/v urography, CT) (% cases) 20.6 33.3 10.33 Appearance of urine on the nephrostomy (days) 4-5 5-6 3-4 RRI/Scintigraphy Obvious decrease in secretion in the operated kidney compared with contralateral After one month p/o (% cases) 29.4 66.6 10.33 Dimensions of the operated kidney on USG one month p/o Length (cm) Width (cm) Parenchyma (cm) 8.2±0.78 3.6±0.57 1.4±0.22 6.9±0.9 3.5±0.3 1.3±0.3 10.4±0.82 4.4±0.62 1.6±0.3

Notă: USG - ultrasonografie, i/v - intravenos, RRI - renografie radioizotopică, p/o - postoperator. Note: USG - ultrasonography, i/v - intravenous, RRI - radioisotopic renography, p/o - postoperative.

În baza rezultatelor obţinute, la pacienţii trataţi conform metodei revendicate indicii funcţiei renale la urografia i/v au fost mai buni în comparaţie cu metoda standard. Apariţia mai precoce a urinei prin nefrostoma rinichiului operat şi cazuri de micşorare în dimensiuni a rinichilor operaţi au fost mai puţine. S-a observat îmbunătăţirea indicilor de acumulare şi secreţie a preparatelor radioizotope la renografia izotopică. La evaluări ecografice repetate s-a evidenţiat păstrarea dimensiunilor normale ale rinichilor operaţi. Based on the results obtained, in patients treated according to the claimed method, renal function indices at i/v urography were better compared to the standard method. Earlier appearance of urine through the nephrostomy of the operated kidney and cases of reduction in size of the operated kidneys were fewer. Improvement of indices of accumulation and secretion of radioisotope preparations at isotopic renography was observed. Repeated ultrasound evaluations revealed preservation of normal sizes of the operated kidneys.

Exemplul 1 Example 1

Pacientul P., 50 ani, a fost internat în mod programat în secţia Urologie SCR, pentru tratament chirurgical, cu diagnosticul: Urolitiază. Calcul renal coraliform pe stânga. Pielonefrită cronică calculoasă pe stânga. La internare acuze la dureri surde permanente în regiunea lombară pe stânga, cu iradiere în regiunea suprapubiană. Se consideră bolnav timp de 7 ani. La investigaţiile preoperatorii: Hb - 157 g/l; er. - 5,37 x 1012/L; leuc. - 9,1x109/L. Nivelul ureei şi creatininei serice în limitele normei. Analiza urinei: acidă, leucocite şi eritrocite multe în c/v; săruri oxalaţi (++). La radiografia reno-vezicală simplă (RRVS) - în proiecţia rinichiului stâng calcul coraliform de 4,0 x 2,7 cm. La urografia i/v - calcul coraliform pe stânga, scăderea secreţiei şi excreţiei pe stânga. La renografia radioizotopică (RRI) - scăderea excreţiei pe stânga. Pacientului i s-a efectuat operaţia: nefrolitotomia pe stânga, fără careva particularităţi tehnice. Din prima zi postoperator pe lângă terapia medicamentoasă de bază (sol. clorură de sodiu 0,9% - 1000 ml/zi - i/v; sol. ceftriaxon 1,0 g x 2 ori/zi - i/m, 10 zile; sol. ciprofloxacină 0,2 % -100 ml 2 ori/zi - i/v, 3 zile; sol. metronidazol 0,5% 100 ml - 2 ori/zi, 3 zile; analgetice - sol. ketorolac 3% 1 ml sau sol. plenalgin 5 ml, sau sol. promedol 2% 1 ml - i/m la dureri; sol. kanefron H 50 pic. 3 ori/zi; sol. acid ascorbic 5% 5 ml - i/v), pacientului i s-a administrat suplimentar, intramuscular, extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 în concentraţie de 0,5% - 1,0 ml, concomitent subcutanat i s-a administrat enoxaparină sodică 2000 UI anti-Xa - 0,2 ml, timp de 10 zile, după care extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02, câte o capsulă de 5 mg, de două ori pe zi, timp de 20 zile. Patient P., 50 years old, was admitted to the Urology Department of the SCR for surgical treatment, with the diagnosis: Urolithiasis. Coraliform renal calculus on the left. Chronic calculous pyelonephritis on the left. Upon admission, he complained of permanent dull pain in the lumbar region on the left, radiating to the suprapubic region. He is considered ill for 7 years. Preoperative investigations: Hb - 157 g/l; er. - 5.37 x 1012/L; leuc. - 9.1x109/L. Serum urea and creatinine levels within normal limits. Urinalysis: acidic, leucocytes and erythrocytes many in c/v; oxalate salts (++). On simple reno-vesical radiography (RRVS) - in the projection of the left kidney, coraliform calculus measuring 4.0 x 2.7 cm. On i/v urography - coraliform calculus on the left, decreased secretion and excretion on the left. On radioisotopic renography (RRI) - decreased excretion on the left. The patient underwent surgery: nephrolithotomy on the left, without any technical particularities. From the first postoperative day, in addition to basic drug therapy (sodium chloride solution 0.9% - 1000 ml/day - i/v; ceftriaxone solution 1.0 g x 2 times/day - i/m, 10 days; ciprofloxacin solution 0.2% -100 ml 2 times/day - i/v, 3 days; metronidazole solution 0.5% 100 ml - 2 times/day, 3 days; analgesics - ketorolac solution 3% 1 ml or plenalgin solution 5 ml, or promedol solution 2% 1 ml - i/m for pain; kanefron H solution 50 pic. 3 times/day; ascorbic acid solution 5% 5 ml - i/v), the patient was additionally administered, intramuscularly, an extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02 in a concentration of 0.5% - 1.0 ml, simultaneously subcutaneously, enoxaparin sodium 2000 IU anti-Xa - 0.2 ml was administered, for 10 days, followed by extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02, one 5 mg capsule, twice a day, for 20 days.

La RRVS de control concremente reziduale nu s-au depistat. La RRI peste o lună şi peste 6 luni după operaţie - funcţia secretorie şi excretorie a rinichiului operat era relativ satisfăcătoare. At the control RRVS, no residual stones were detected. At the RRI one month and six months after the operation - the secretory and excretory function of the operated kidney was relatively satisfactory.

Exemplul 2 Example 2

Pacienta N., 32 ani, a fost internată în mod programat în secţia Urologie SCR, pentru tratament chirurgical, cu diagnosticul: Urolitiază. Calcul renal coraliform pe stânga. Pielonefrită cronică calculoasă pe stânga. La internare acuze la dureri lombare surde pe stânga cu iradiere pe traiectul ureterului. Se consideră bolnavă timp de 3 luni. Analiza sângelui fără modificări patologice. Nivelul ureei şi creatininei serice în limitele normei. Urina acidă, cu leuciturie şi fosfaturie. La RRVS - în proiecţia rinichiului stâng calcul coraliform de 4,0 x 3,5 cm. La urografia i/v - calcul coraliform pe stânga, scăderea secreţiei şi excreţiei pe stânga. La RRI - scăderea excreţiei bilateral. Pacientei i s-a efectuat operaţia: nefrolitotomia şi nefrostomia pe stânga. La revizia rinichiului stâng - bazinet complet intrarenal. În condiţii tehnice dificile s-a efectuat nefrolitotomia pe pensa vasculară, durata clampării timp de 25 minute, sub protecţia hipotermiei. Aplicată nefrostoma. Parenchimul renal suturat în suturi etajate. Plaga postoperatorie drenată, suturată în planuri anatomice. Din prima zi după operaţie, în afară de terapia medicamentoasă standard (sol. ceftriaxon 1 g x 2 ori/zi - i/m 10 zile; sol. ciprofloxacină 0,2% - 100 ml 2 ori/zi - i/v, 3 zile; sol. metronidazol 0,5% 100 ml - 2 ori/zi, 3 zile; sol. clorură de sodiu 0,9% - 1000 ml/zi - i/v; sol. acid ascorbic 5% 5 ml - i/v; analgetice - sol. ketorolac 3% 1 ml sau sol. plenalgin 5 ml, sau sol. promedol 2% 1 ml - i/m la dureri; sol. kanefron H 50 pic. - 3 ori/zi), pacientului i s-a administrat suplimentar, intramuscular, extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 în concentraţie de 0,5% - 1,0 ml, concomitent subcutanat i s-a administrat enoxaparină sodică 2000 UI anti-Xa - 0,2 ml, timp de 10 zile. Patient N., 32 years old, was admitted to the Urology Department of the SCR for surgical treatment, with the diagnosis: Urolithiasis. Coraliform renal calculus on the left. Chronic calculous pyelonephritis on the left. Upon admission, she complained of dull lumbar pain on the left with irradiation along the ureter. She is considered ill for 3 months. Blood analysis without pathological changes. Serum urea and creatinine levels within normal limits. Acidic urine, with leukuria and phosphaturia. On RRVS - in the projection of the left kidney, coraliform calculus measuring 4.0 x 3.5 cm. On i/v urography - coraliform calculus on the left, decreased secretion and excretion on the left. On RRI - decreased excretion bilaterally. The patient underwent surgery: nephrolithotomy and nephrostomy on the left. On revision of the left kidney - complete intrarenal pelvis. In difficult technical conditions, nephrolithotomy was performed on vascular clamps, the clamping duration was 25 minutes, under the protection of hypothermia. Nephrostoma applied. Renal parenchyma sutured in tiered sutures. Postoperative wound drained, sutured in anatomical planes. From the first day after surgery, in addition to standard drug therapy (ceftriaxone solution 1 g x 2 times/day - i/m 10 days; ciprofloxacin solution 0.2% - 100 ml 2 times/day - i/v, 3 days; metronidazole solution 0.5% 100 ml - 2 times/day, 3 days; sodium chloride solution 0.9% - 1000 ml/day - i/v; ascorbic acid solution 5% 5 ml - i/v; analgesics - ketorolac solution 3% 1 ml or plenalgin solution 5 ml, or promedol solution 2% 1 ml - i/m for pain; kanefron H solution 50 pic. - 3 times/day), the patient was additionally administered, intramuscularly, extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02 in a concentration of 0.5% - 1.0 ml, simultaneously Enoxaparin sodium 2000 IU anti-Xa - 0.2 ml was administered subcutaneously for 10 days.

La a 4-a zi postoperator diureză pe nefrostomă 800 ml. Pacienta a fost externată în stare satisfăcătoare la a 13-a zi cu prelungirea tratamentului cu extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02, câte o capsulă de 5 mg, de două ori pe zi, timp de 20 zile. La RRVS de control fragmente reziduale nu s-au depistat. La RRI peste 1 lună şi peste 6 luni după operaţie funcţia secretorie şi excretorie a rinichiului operat era relativ satisfăcătoare. On the 4th postoperative day, diuresis on nephrostomy 800 ml. The patient was discharged in satisfactory condition on the 13th day with the extension of treatment with extract from the biomass of the cyanobacterial strain Spirulina platensis CNM - CB - 02, one capsule of 5 mg, twice a day, for 20 days. At the control RRVS, residual fragments were not detected. At the RRI after 1 month and after 6 months after the operation, the secretory and excretory function of the operated kidney was relatively satisfactory.

1.Protocolul naţional. Urolitiaza la adulţi. Chişinău, 2009, p-14-40, găsit în internet, URL: http://www.ms.gov.md/_files/6157-PCN-88%2520UA.pdf 1. National Protocol. Urolithiasis in adults. Chisinau, 2009, p-14-40, found on the internet, URL: http://www.ms.gov.md/_files/6157-PCN-88%2520UA.pdf

Claims (1)

Metodă de tratament postoperator al pacienţilor cu litiază renală, care include administrarea antibioticelor, remediilor antispastice, antioxidante, terapia de dezintoxicare şi fitoterapia, caracterizată prin aceea că din prima zi după operaţie, suplimentar, intramuscular, se administrează extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02 în concentraţie de 0,5% - 1,0 ml, concomitent subcutanat se administrează enoxaparină sodică 2000 UI anti-Xa - 0,2 ml, timp de 10 zile, după care se administrează extract din biomasa tulpinii cianobacteriei Spirulina platensis CNM - CB - 02, câte o capsulă de 5 mg, de două ori pe zi, timp de 20 zile.Method of postoperative treatment of patients with renal lithiasis, which includes the administration of antibiotics, antispasmodic remedies, antioxidants, detoxification therapy and phytotherapy, characterized by the fact that from the first day after surgery, additionally, intramuscularly, extract from the biomass of the cyanobacteria strain Spirulina platensis CNM - CB - 02 is administered in a concentration of 0.5% - 1.0 ml, simultaneously subcutaneously enoxaparin sodium 2000 IU anti-Xa - 0.2 ml, for 10 days, after which extract from the biomass of the cyanobacteria strain Spirulina platensis CNM - CB - 02 is administered, one capsule of 5 mg, twice a day, for 20 days.
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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104435184A (en) * 2013-09-25 2015-03-25 廖国建 Drug for treating kidney stone

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SU1324669A1 (en) * 1985-12-30 1987-07-23 Всесоюзный научно-исследовательский институт химии и технологии лекарственных средств Agent for curing urolithiasis
SU1572625A1 (en) * 1987-12-28 1990-06-23 Центральная Медико-Санитарная Часть N15 Method of treating urolithiasis
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Publication number Priority date Publication date Assignee Title
SU1324669A1 (en) * 1985-12-30 1987-07-23 Всесоюзный научно-исследовательский институт химии и технологии лекарственных средств Agent for curing urolithiasis
SU1572625A1 (en) * 1987-12-28 1990-06-23 Центральная Медико-Санитарная Часть N15 Method of treating urolithiasis

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104435184A (en) * 2013-09-25 2015-03-25 廖国建 Drug for treating kidney stone

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