MD927Z - Method for treatment of anaerobic spontaneous peritonitis in decompensated hepatocirrhosis with hepato-renal syndrome - Google Patents
Method for treatment of anaerobic spontaneous peritonitis in decompensated hepatocirrhosis with hepato-renal syndrome Download PDFInfo
- Publication number
- MD927Z MD927Z MDS20140121A MDS20140121A MD927Z MD 927 Z MD927 Z MD 927Z MD S20140121 A MDS20140121 A MD S20140121A MD S20140121 A MDS20140121 A MD S20140121A MD 927 Z MD927 Z MD 927Z
- Authority
- MD
- Moldova
- Prior art keywords
- drain
- antibiotics
- nacl
- treatment
- ascitic fluid
- Prior art date
Links
- 238000000034 method Methods 0.000 title claims abstract description 18
- 206010034674 peritonitis Diseases 0.000 title claims description 5
- 201000011200 hepatorenal syndrome Diseases 0.000 title claims description 4
- 230000002269 spontaneous effect Effects 0.000 title claims description 4
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims abstract description 17
- 210000003567 ascitic fluid Anatomy 0.000 claims abstract description 12
- 239000003242 anti bacterial agent Substances 0.000 claims abstract description 10
- 229940088710 antibiotic agent Drugs 0.000 claims abstract description 10
- 239000003814 drug Substances 0.000 claims abstract description 6
- 238000002560 therapeutic procedure Methods 0.000 claims abstract description 6
- 229930186147 Cephalosporin Natural products 0.000 claims abstract description 5
- 229940124587 cephalosporin Drugs 0.000 claims abstract description 5
- 150000001780 cephalosporins Chemical class 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
- 239000002934 diuretic Substances 0.000 claims abstract description 5
- 210000001015 abdomen Anatomy 0.000 claims abstract description 4
- 150000001413 amino acids Chemical class 0.000 claims abstract description 4
- 230000005587 bubbling Effects 0.000 claims abstract description 4
- 229940079593 drug Drugs 0.000 claims abstract description 4
- 239000003120 macrolide antibiotic agent Substances 0.000 claims abstract description 4
- 238000007911 parenteral administration Methods 0.000 claims abstract description 4
- 238000002360 preparation method Methods 0.000 claims description 5
- 108010065073 lidase Proteins 0.000 claims description 4
- 208000019425 cirrhosis of liver Diseases 0.000 claims description 3
- 230000001882 diuretic effect Effects 0.000 claims description 3
- 239000011780 sodium chloride Substances 0.000 claims 2
- 229940041033 macrolides Drugs 0.000 abstract 1
- 206010003445 Ascites Diseases 0.000 description 6
- 208000004880 Polyuria Diseases 0.000 description 3
- 230000001580 bacterial effect Effects 0.000 description 3
- 238000003745 diagnosis Methods 0.000 description 3
- 230000035619 diuresis Effects 0.000 description 3
- 206010037660 Pyrexia Diseases 0.000 description 2
- 229960004755 ceftriaxone Drugs 0.000 description 2
- 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 description 2
- 230000002443 hepatoprotective effect Effects 0.000 description 2
- 239000000203 mixture Substances 0.000 description 2
- -1 1g 2 times a day Chemical compound 0.000 description 1
- 208000004998 Abdominal Pain Diseases 0.000 description 1
- 102000009027 Albumins Human genes 0.000 description 1
- 108010088751 Albumins Proteins 0.000 description 1
- 201000003126 Anuria Diseases 0.000 description 1
- 206010062070 Peritonitis bacterial Diseases 0.000 description 1
- 208000001647 Renal Insufficiency Diseases 0.000 description 1
- 210000000683 abdominal cavity Anatomy 0.000 description 1
- 230000003187 abdominal effect Effects 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 229960004821 amikacin Drugs 0.000 description 1
- LKCWBDHBTVXHDL-RMDFUYIESA-N amikacin Chemical compound O([C@@H]1[C@@H](N)C[C@H]([C@@H]([C@H]1O)O[C@@H]1[C@@H]([C@@H](N)[C@H](O)[C@@H](CO)O1)O)NC(=O)[C@@H](O)CCN)[C@H]1O[C@H](CN)[C@@H](O)[C@H](O)[C@H]1O LKCWBDHBTVXHDL-RMDFUYIESA-N 0.000 description 1
- 230000000844 anti-bacterial effect Effects 0.000 description 1
- 150000005693 branched-chain amino acids Chemical class 0.000 description 1
- 229960000484 ceftazidime Drugs 0.000 description 1
- NMVPEQXCMGEDNH-TZVUEUGBSA-N ceftazidime pentahydrate Chemical compound O.O.O.O.O.S([C@@H]1[C@@H](C(N1C=1C([O-])=O)=O)NC(=O)\C(=N/OC(C)(C)C(O)=O)C=2N=C(N)SC=2)CC=1C[N+]1=CC=CC=C1 NMVPEQXCMGEDNH-TZVUEUGBSA-N 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 238000001784 detoxification Methods 0.000 description 1
- 229940030606 diuretics Drugs 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 230000004054 inflammatory process Effects 0.000 description 1
- 201000006370 kidney failure Diseases 0.000 description 1
- 238000007449 liver function test Methods 0.000 description 1
- 210000003622 mature neutrocyte Anatomy 0.000 description 1
- 229960000282 metronidazole Drugs 0.000 description 1
- VAOCPAMSLUNLGC-UHFFFAOYSA-N metronidazole Chemical compound CC1=NC=C([N+]([O-])=O)N1CCO VAOCPAMSLUNLGC-UHFFFAOYSA-N 0.000 description 1
- 230000004089 microcirculation Effects 0.000 description 1
- 230000008506 pathogenesis Effects 0.000 description 1
- 230000001717 pathogenic effect Effects 0.000 description 1
- 230000010412 perfusion Effects 0.000 description 1
- 208000007232 portal hypertension Diseases 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
Landscapes
- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
Abstract
Description
Invenţia se referă la medicină, în special la hepatologie. The invention relates to medicine, in particular to hepatology.
Este cunoscută metoda de tratament al ascit-peritonitei bacteriene spontane, care constă în efectuarea laparocentezei de volum cu evacuarea lichidului ascitic contaminat şi administrarea i/v a antibioticelor, şi anume a preparatelor din grupa cefalosporinelor de generaţia III (ceftriaxonă, câte 1 g de 2 ori pe zi, timp de 5...7 zile), a preparatelor hepatoprotectoare, diuretice şi a aminoacizilor cu catenă ramificată [1]. The method of treatment of spontaneous bacterial ascites-peritonitis is known, which consists of performing volume laparocentesis with evacuation of contaminated ascitic fluid and i/v administration of antibiotics, namely preparations from the group of cephalosporins of the third generation (ceftriaxone, 1 g 2 times a day, for 5...7 days), hepatoprotective preparations, diuretics and branched-chain amino acids [1].
Dezavantajul metodei date constă în eficacitatea redusă şi procentul înalt de mortalitate din cauza progresării procesului septic intraabdominal şi a insuficienţei renale. The disadvantage of this method is its low effectiveness and high mortality rate due to the progression of intra-abdominal septic process and renal failure.
Problema pe care o rezolvă invenţia constă în extinderea gamei metodelor de tratament al peritonitei spontane bacteriene anaerobe, care ar face posibilă rezolvarea procesului septic anaerob intraabdominal şi corecţia sindromului hepato-renal, mărirea resorbţiei ascitei şi ameliorarea stării pacientului într-o perioadă scurtă de timp. The problem solved by the invention consists in expanding the range of treatment methods for spontaneous anaerobic bacterial peritonitis, which would make it possible to resolve the intra-abdominal anaerobic septic process and correct the hepatorenal syndrome, increase the resorption of ascites and improve the patient's condition in a short period of time.
Conform invenţiei, metoda revendicată constă în aceea că se efectuează terapia intensivă, care include administrarea parenterală a antibioticelor, hepatoprotectoarelor, plasmei, aminoacizilor, preparatelor reologice şi diuretice, iar suplimentar se efectuează laparocenteza cu evacuarea a 3…5 L de lichid ascitic contaminat, se instalează un dren în etajul inferior al abdomenului, prin care se insuflă O2 în cantitate de 1000…3000 cm3, barbotându-l prin lichidul ascitic restant timp de 2…3 min, apoi prin dren se introduce consecutiv lidază 370…640 U dizolvată în 200…500 ml de sol. NaCl 0,9%, dexametazon 8…16 mg dizolvat în 100…200 ml de sol. NaCl 0,9% şi antibiotice din grupele cefalosporinelor şi macrolidelor dizolvate în 200…500 ml de sol. NaCl 0,9%, procedura de introducere a medicamentelor prin dren se repetă de 1…2 ori pe zi, timp de 3…5 zile. According to the invention, the claimed method consists in performing intensive therapy, which includes parenteral administration of antibiotics, hepatoprotectors, plasma, amino acids, rheological and diuretic preparations, and additionally performing laparocentesis with evacuation of 3…5 L of contaminated ascitic fluid, installing a drain in the lower abdomen, through which O2 is insufflated in an amount of 1000…3000 cm3, bubbling it through the remaining ascitic fluid for 2…3 min, then through the drain, 370…640 U of lidase dissolved in 200…500 ml of 0.9% NaCl solution, 8…16 mg of dexamethasone dissolved in 100…200 ml of 0.9% NaCl solution and antibiotics from the cephalosporin and macrolide groups dissolved in 200…500 ml of 0.9% NaCl solution are consecutively introduced. NaCl 0.9%, the procedure for introducing drugs through the drain is repeated 1...2 times a day, for 3...5 days.
Rezultatul invenţiei constă în atenuarea procesului septic intraabdominal acut prin distrugerea florei patogene şi îndeosebi a celei anaerobe, micşorarea procesului inflamator peritoneal, ameliorarea microcirculaţiei peritoneului, reducerea presiunii intraabdominale, care duce la micşorarea compresiei parenchimului renal, sporirea proceselor de resorbţie a lichidului ascitic şi a perfuziei renale cu restabilirea diurezei şi ameliorarea stării generale a pacienţilor. The result of the invention consists in alleviating the acute intra-abdominal septic process by destroying the pathogenic flora, especially the anaerobic one, reducing the peritoneal inflammatory process, improving the peritoneal microcirculation, reducing the intra-abdominal pressure, which leads to reducing the compression of the renal parenchyma, increasing the processes of resorption of ascitic fluid and renal perfusion with the restoration of diuresis and improving the general condition of patients.
Metoda se efectuează în modul următor. The method is performed in the following way.
Se efectuează terapia intensivă, care include administrarea parenterală a antibioticelor, hepatoprotectoarelor, plasmei, aminoacizilor, preparatelor reologice şi diuretice, iar suplimentar se efectuează laparocenteza cu evacuarea a 3…5 L de lichid ascitic contaminat, se instalează un dren în etajul inferior al abdomenului, prin care se insuflă O2 în cantitate de 1000…3000 cm3, barbotându-l prin lichidul ascitic restant timp de 2…3 min, apoi prin dren se introduce consecutiv lidază 370…640 U dizolvată în 200…500 ml de sol. NaCl 0,9%, dexametazon 8…16 mg dizolvat în 100…200 ml de sol. NaCl 0,9% şi antibiotice din grupele cefalosporinelor şi macrolidelor dizolvate în 200…500 ml de sol. NaCl 0,9%, procedura de introducere a medicamentelor prin dren se repetă de 1…2 ori pe zi, timp de 3…5 zile. Intensive therapy is performed, which includes parenteral administration of antibiotics, hepatoprotectors, plasma, amino acids, rheological and diuretic preparations, and additionally laparocentesis is performed with the evacuation of 3…5 L of contaminated ascitic fluid, a drain is installed in the lower abdomen, through which O2 is insufflated in an amount of 1000…3000 cm3, bubbling it through the remaining ascitic fluid for 2…3 min, then through the drain, lidase 370…640 U dissolved in 200…500 ml of sol. NaCl 0.9%, dexamethasone 8…16 mg dissolved in 100…200 ml of sol. NaCl 0.9% and antibiotics from the cephalosporin and macrolide groups dissolved in 200…500 ml of sol. NaCl 0.9%, the procedure for introducing drugs through the drain is repeated 1...2 times a day, for 3...5 days.
Metoda revendicată a fost utilizată pentru tratamentul a 27 de pacienţi. The claimed method was used for the treatment of 27 patients.
Exemplu Example
Pacientul S., 59 ani, a fost internat în secţia chirurgie septică cu diagnosticul: ciroză hepatică decompensată HCV Child "C"(13), hipertensiune portală, ascit-peritonită bacteriană anaerobă, sindrom hepato-renal, dureri abdominale, febră, oligoanurie. S-a efectuat terapia infuzională de detoxicare, reologică, hepatoprotectoare, transfuzii de plasmă, albumină, diureza forţată, terapia antibacteriană parenterală cu ceftazidim, 1g de 2 ori pe zi, şi metronidazol, 100 mg de 2 ori pe zi i/v, care nu a avut efect de ameliorare a stării pacientului. S-a efectuat puncţia cavităţii abdominale cu examinarea lichidului ascitc la neutrofile polimorfonucleare (NPN), care s-a stabilit la nivelul de 370 mm3, ce a confirmat diagnosticul de peritonită spontană bacteriană. Patient S., 59 years old, was admitted to the septic surgery department with the diagnosis: decompensated liver cirrhosis HCV Child "C" (13), portal hypertension, anaerobic bacterial ascites-peritonitis, hepatorenal syndrome, abdominal pain, fever, oligoanuria. Infusional detoxification, rheological, hepatoprotective therapy, plasma transfusions, albumin, forced diuresis, parenteral antibacterial therapy with ceftazidime, 1g 2 times a day, and metronidazole, 100 mg 2 times a day i/v, which had no effect on improving the patient's condition, was performed. Abdominal cavity puncture was performed with examination of ascites fluid for polymorphonuclear neutrophils (NPN), which was established at the level of 370 mm3, which confirmed the diagnosis of spontaneous bacterial peritonitis.
Apoi s-a efectuat laparocenteza cu evacuarea a 5 L de lichid ascitic contaminat, s-a instalat un dren în etajul abdominal inferior, prin care s-a introdus O2 în cantitate de 3000 cm3, care s-a barbotat prin lichidul ascitic restant timp de 3 min. Consecutiv prin dren s-a introdus un amestec de lidază 640 U cu sol. NaCI 0,9% în cantitate de 500 ml, dexametazon 16 mg şi un amestec de antibiotice, şi anume ceftriaxon 4g şi amicacin 1000 mg cu sol. NaCI 0,9% în cantitate de 200 ml, după care drenul s-a închis. Cura de tratament s-a repetat o dată pe zi timp de 3 zile. La 48 ore după prima procedură starea generală s-a ameliorat, a dispărut febra, s-a restabilit diureza, ascita s-a micşorat, probele funcţionale hepatice s-au ameliorat. Pacientul a fost externat pentru tratament ambulator peste 8 zile. Then laparocentesis was performed with the evacuation of 5 L of contaminated ascitic fluid, a drain was installed in the lower abdominal floor, through which O2 was introduced in an amount of 3000 cm3, which was bubbled through the remaining ascitic fluid for 3 min. Subsequently, a mixture of lidase 640 U with sol. NaCl 0.9% in an amount of 500 ml, dexamethasone 16 mg and a mixture of antibiotics, namely ceftriaxone 4g and amikacin 1000 mg with sol. NaCl 0.9% in an amount of 200 ml, was introduced through the drain, after which the drain was closed. The treatment course was repeated once a day for 3 days. 48 hours after the first procedure, the general condition improved, the fever disappeared, diuresis was restored, ascites decreased, liver function tests improved. The patient was discharged for outpatient treatment after 8 days.
1. Андреев Г.Н., Борисов А. В., Ибадильдин А. С. и др. Патогенез, диагностика и лечение циррозов печени, осложненных резистентным асцитом. Великий Новгород, 1999, с. 140-144 1. Andreev G.N., Borisov A. V., Ibadildin A. С. and others Pathogenesis, diagnosis and treatment of liver cirrhosis complicated by resistant ascites. Veliky Novgorod, 1999, p. 140-144
Claims (1)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20140121A MD927Z (en) | 2014-09-11 | 2014-09-11 | Method for treatment of anaerobic spontaneous peritonitis in decompensated hepatocirrhosis with hepato-renal syndrome |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20140121A MD927Z (en) | 2014-09-11 | 2014-09-11 | Method for treatment of anaerobic spontaneous peritonitis in decompensated hepatocirrhosis with hepato-renal syndrome |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| MD927Y MD927Y (en) | 2015-07-31 |
| MD927Z true MD927Z (en) | 2016-02-29 |
Family
ID=53773724
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| MDS20140121A MD927Z (en) | 2014-09-11 | 2014-09-11 | Method for treatment of anaerobic spontaneous peritonitis in decompensated hepatocirrhosis with hepato-renal syndrome |
Country Status (1)
| Country | Link |
|---|---|
| MD (1) | MD927Z (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| 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 (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| MD774Y (en) * | 2013-09-12 | 2014-05-31 | Gheorghe Anghelici | Endoscopic method for treating cirrhotic spontaneous ascites-peritonitis |
-
2014
- 2014-09-11 MD MDS20140121A patent/MD927Z/en not_active IP Right Cessation
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| MD774Y (en) * | 2013-09-12 | 2014-05-31 | Gheorghe Anghelici | Endoscopic method for treating cirrhotic spontaneous ascites-peritonitis |
Non-Patent Citations (1)
| Title |
|---|
| Андреев Г.Н., Борисов А. В., Ибадильдин А. С. и др. Патогенез, диагностика и лечение циррозов печени, осложненных резистентным асцитом. Великий Новгород, 1999, с. 140-144 * |
Also Published As
| Publication number | Publication date |
|---|---|
| MD927Y (en) | 2015-07-31 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| IL299024B1 (en) | Tripeptidyl peptidase-1 preparations and methods for treating neuronal ceroid lipofuscinosis | |
| RU2017134443A (en) | METHOD OF TREATMENT WITH USE OF TRADIPTANT | |
| MD927Z (en) | Method for treatment of anaerobic spontaneous peritonitis in decompensated hepatocirrhosis with hepato-renal syndrome | |
| Wong | Clinical consequences of infection in cirrhosis: organ failures and acute‐on‐chronic liver failure | |
| MD926Z (en) | Method of laparoscopic treatment of spontaneous bacterial ascites-peritonitis in decompensated liver cirrhosis | |
| CN106866790A (en) | The preparation method of Daptomycin RS-5/6, RS-7 and RS-7a/7b impurity | |
| CN1149988C (en) | Drugs for Liver Diseases | |
| MD3444F1 (en) | Method of treating the spontaneous bacterial peritonitis in the decompensated hepatic cirrhosis with resistant ascitic syndrome | |
| MD1560Z (en) | Method for minimally invasive treatment of bacterial spontaneous ascites-peritonitis in patients with decompensated liver cirrhosis | |
| US6878688B2 (en) | Method of treatment of malignant neoplasms and complex preparation having antineoplastic activity for use in such treatment | |
| MD774Y (en) | Endoscopic method for treating cirrhotic spontaneous ascites-peritonitis | |
| Trollfors et al. | Effects on renal function of treatment with cefoxitin sodium alone or in combination with furosemide | |
| AR111313A1 (en) | OSMÓTICALLY ACTIVE COMPOSITION FOR DIALYSIS | |
| WO2017114224A1 (en) | Creatine mother liquid separation and purification processing system | |
| RU2605826C1 (en) | Injection preparation based on drotaverine and preparation method thereof | |
| Song et al. | A Blood Anticoagulant Substance from Garlic (Allium Sativum): I. Its Preparation and Studies on its Anticoagulant Effect | |
| Duckett et al. | The effect of cambendazole on Trichinella spiralis infections in mice | |
| JP6179939B2 (en) | Method for reducing viscosity of high-concentration gamma globulin preparation | |
| UA143609U (en) | Ion exchange catalyst | |
| JPH038361B2 (en) | ||
| Yazkan et al. | Iodopovidone pleurodesis in the treatment of refractory pleural effusions | |
| SU1319856A1 (en) | Method of treatment of postoperational enteroparesis | |
| Berdicevsky et al. | Reversal by calcium ions of the growth inhibition of Debaryomyces nicotianae caused by antifungal polyene antibiotics | |
| WO2021133367A1 (en) | Method for intensifying ion exchange processes | |
| Mizumura et al. | Continuous administration of vancomycin through a long intestinal tube for Clostridium difficile infection |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FG9Y | Short term patent issued | ||
| KA4Y | Short-term patent lapsed due to non-payment of fees (with right of restoration) | ||
| MM4Y | Short-term patent definitely lapsed due to non-payment of fees |