RU2005512C1 - Method for treatment of destructive pancreatitis - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves intravascular irradiation of blood for four days beginning with the next postoperative day. Blood is irradiated with low-intensive laser radiation 60 minutes a day. On the first day after irradiation, up to 20 thousand units of contrical are introduced intravenously. On the 2nd and 3rd days 10 thousand units are given at a time , mixed in a 1: 2 proportion with a standard solvent. The method increases efficiency of treatment, reduces substantially the time of hospitalization, the amount of required costly inhibitor, and the number of venipunctures for laser irradiation of blood. EFFECT: higher efficiency and shorter treatment of patients with destructive pancreatitis within postoperative period.

Description

 The invention relates to medicine, namely to postoperative treatment of destructive pancreatitis.

 The aim of the invention is to increase the efficiency and reduce the time of treatment of patients with destructive pancreatitis in the postoperative period.

 The method is as follows. The patient the next day after surgery is daily administered intravascular laser irradiation of blood for 60 minutes for 4 days. After laser irradiation, the patient is administered intravenously in a syringe Contrical, on the first day up to 20 thousand units, on the second and third days, 10 thousand units in a ratio of 1: 2 with a standard solvent.

PRI me R. Patient S., 35 years old, with complaints of severe pain in the upper abdomen, nausea, vomiting. The general condition is serious. Pulse 88 beats. / min, satisfactory qualities. Body temperature 36.2 ^o C. In the lungs, vesicular breathing. The abdomen is moderately swollen, sharp pain in the epigastrium, symptoms of peritoneal irritation are not pronounced.

Blood tests: L 13.0˙10 ⁹ / l; ESR 3 mm / h, total bilirubin 14.6 µol / l; AlAt 189.0 nmol (s); AcAt 111.2 nmol / sl; total protein 78.9 g / l. Total antitryptic activity (OATA) 31.11 IE / ml. Kallikrein (K) 25.78 mKE. Prekallikrein 246.41 mKE.

 Diagnosis: acute pancreatitis.

 Conducted infusion therapy, analgesics, spasmolytics were introduced. Despite the treatment, the patient's condition worsened. Due to the increase in the clinical picture of peritonitis, the patient was operated on 12 hours after receipt. Produced cholecystectomy, drainage of the omental bursa and abdominal cavity.

The postoperative period was difficult. Intoxication phenomena have progressed. Body temperature increased to 38 ^about C.

 A course of low-intensity intravascular laser irradiation of blood in combination with contracal has begun. Laser irradiation was performed with the ALOK-1 apparatus through a flexible optical fiber with a power output of 1 MW, introduced into the vein through a needle from the system for a single blood transfusion, the next day after the operation, laser irradiation of blood is performed for 60 minutes, then up to 20 thousand units of contrycal are administered intravenously, on the second day - irradiation of 60 minutes and 10 thousand units of counter-radiation, on the third day - irradiation of 60 minutes, 10 thousand units of counter-radiation, on the fourth day - irradiation of 60 minutes laser irradiation of blood. A blood test showed that on the third day: OATA 36.25 IE / ml, K 18.7 MkE, PK 278.18 MKE.

 On the fifth day: OATA 46.4 IE / ml, K 11.46 IU, PK 343.6 IU, i.e. the norm.

 There were no complications from the treatment. The general condition of the patient gradually improved. The wound healed by primary intention.

Blood tests at discharge: L 9.6˙10 ⁹ / l; ESR 8 ml / h; total bilirubin 6.84 µol / l; ALAT 126.7 nmol (s); ASAT 92.8 nmol (s); total protein 78.9 g / l.

 The patient is in satisfactory condition. The length of hospital stay was 13 days.

 The developed treatment method allows for more effective treatment of patients with destructive pancreatitis in the postoperative period.

 The patient’s stay in the hospital is reduced to 13 days, while with the known methods the course of treatment was 3-4 weeks. The combined use can significantly reduce the amount of expensive inhibitor.

 The frequency of venipuncture for laser irradiation of blood is reduced to 4 times instead of 6.

 6 patients with destructive pancreatitis were treated in the postoperative period. There were no complications from the treatment. All patients were discharged in satisfactory condition a few days earlier compared to known methods of treatment. (56) V.S. Zemskov et al. Use of intravascular low-energy laser blood irradiation in the treatment of destructive pancreatitis. Clinical Surgery 1984. N 11, p. 69.

Claims (1)

 METHOD FOR TREATING DESTRUCTIVE PANCREATITIS, including exposure to blood of low-intensity laser irradiation, characterized in that, in order to reduce treatment time, laser irradiation is performed on the day after surgery for 4 days for 60 minutes, on the 1st day after irradiation Contracal is administered intravenously up to 20 thousand units, on the 2nd and 3rd day after irradiation, 10 thousand units in a ratio of 1: 2 with a standard solvent.