RU2110264C1 - Method of malignant diphtheria treatment - Google Patents

Abstract

FIELD: medicine, infectious pathology. SUBSTANCE: method involves disintoxicating therapy carrying out on background of complex therapy by ozone administration which is a component of solutions to be administrated - glucose, saline solutions, blood protein preparations. Method can be used for treatment of patients with developing carditis. EFFECT: enhanced effectiveness of treatment. 2 cl, 1 tbl

Description

 The invention relates to medicine, namely to infectious pathology, and can be used to treat toxic diphtheria.

 Since 1990, the incidence of diphtheria has been steadily increasing, and in some areas of Russia it currently corresponds to the level of the 30s and 40s, which amounts to more than 100 cases per 100,000 population. Moreover, the severity coefficient (the number of toxic forms) reaches 15 - 20%, which leads to high mortality (up to 2.2%). The incidence of diphtheria is observed in all age groups, both among children and adults. Mortality from diphtheria among mortality from infectious diseases has come first.

 Known methods for the treatment of toxic diphtheria, one of which is a method based on the method of plasmapheresis [1]. This method allows the treatment of toxic diphtheria in complex therapy. However, it is quite traumatic and requires transfusion of a large amount of donor plasma. In addition, during transfusion of donor plasma, there is a likelihood of the patient becoming infected with various infections, in particular viral hepatitis transmitted by the parenteral route.

 The closest set of essential features to the proposed method is a method for the treatment of toxic diphtheria, which is selected as a prototype.

 The known method on the background of complex therapy, including the introduction of antidiphtheria serum, is carried out by detoxification infusion therapy, namely the introduction of a parenteral solution of glucose, saline solutions, protein preparations of blood and blood substitutes daily for 1 to 10 days, depending on the severity of the patient's condition [2] .

 Conducting detoxification infusion therapy on the background of complex therapy, including the introduction of anti-diphtheria serum, can effectively treat toxic diphtheria.

 However, detoxification infusion therapy is not effective enough. In addition, a large volume of injected solutions is contraindicated in carditis, which often develops with toxic diphtheria, and injected blood substitutes, which circulate in the vascular bed for a long time, have a side effect, in particular, on the kidneys.

 The objective of the proposed method is to increase the effectiveness of treatment of toxic diphtheria, in particular, with developing carditis, and the elimination of side effects on the body of blood substitutes.

 The problem is solved by a known method for the treatment of toxic diphtheria by detoxification infusion therapy, including the administration of a parenteral glucose solution, saline solutions of blood protein preparations against the background of complex therapy, ozone is additionally administered according to the invention, saturating with it part of one of the injected solutions.

 Most preferred is the saturation with ozone of a portion of the glucose solution, which is 15-20% of the total number of infusion solutions administered, while the glucose solution contains ozone in an amount of 4.0-6.0 μg / L, since the saturation of the saline solution with ozone leads to sodium hypochloride, which may have an undesirable effect on the body.

The introduction of additional ozone into the patient’s body, which is saturated with part of one of the injected solutions, in particular glucose solution, allows you to activate metabolic processes in the body and increase the antioxidant defense of the body by activating enzymes involved in the purification of oxygen or peroxide radicals (glutathione, catalysis, superoxide dismutase ); the acceleration of glycolysis in red blood cells, which results in the stimulation of the 2,3-bisphosphoglycerate cycle, which shifts the oxyhemoglobin dissociation curve to the right, thus releasing oxygen for tissues. Further physiological effects include increased oxidative decarboxination of pyruvate to form acetyl-CoA and subsequent activation of the citric acid cycle. Direct effect on the mitochondrial transfer system with a decrease in nicotinamide adenine dinucleotide phosphate and oxidation of cytochromes. Increased red blood cell elasticity, rheological properties of blood and arterial PO ₂ .

 As a molecule containing a large amount of energy, ozone exhibits a bactericidal, virucidal and fungicidal effect.

 Ozone is saturated with such a volume of the injected glucose solution, which is 15 - 20% of the total number of injected infusion solutions, while the ozone content in the solution is 4.0 - 6.0 μg / L.

 Due to the introduction of ozone into the patient’s body, it became possible to reduce the amount of infusion solutions administered while maintaining the effectiveness of treatment of toxic diphtheria even in patients with developing carditis, as well as to eliminate the introduction of blood substitutes that have a side effect on the body.

 Daily or every other day it is necessary to introduce ozone in the amount of 4.0 - 6.0 μg / l. The introduction of ozone of less than 4.0 μg / l does not have a positive effect, and the introduction of ozone of more than 6.0 μg / l can lead to a negative effect in the form of activation of lipid peroxidation processes. The course of treatment in this case is 1 to 5 procedures, depending on the severity of the patient's condition.

 Analysis of scientific, technical and patent documentation showed that the proposed method is "new" and meets the criterion of "inventive step".

 The proposed method is as follows.

 A patient with toxic diphtheria during complex therapy, including the introduction of antidiphtheria serum, is treated with detoxification infusion therapy by administering parenterally daily or every other day for 1 to 10 days, depending on the severity of the patient, 100-200 ml of 5% glucose solution depending on age a patient who previously ozonized by passing an ozone-oxygen mixture through it, while the ozone content in the solution is 4.0 - 6.0 μg / l, 5% glucose solution, isotonic salt solution, in particular STI, Acesol, Chlosol et al., blood protein preparations.

The proposed method was used to treat a group of patients with toxic forms of diphtheria, consisting of 20 children who had a different severity of the disease, namely:
subtoxic oropharyngeal diphtheria - in 4 children,
toxic I degree - in 3 children,
toxic II degree - in 10 children,
toxic III degree - in 3 children.

 The results are shown in the table.

 The table shows the results of treatment of 20 children with toxic diphtheria treated using the known and proposed methods.

 With ozone therapy, the normalization of the general urine analysis is reduced by 2 times, the number of leukocytes in the general blood test and the leukocyte intoxication index are normalized 1.5-2 times faster, the edema of the subcutaneous tissue of the neck and fibrinous deposits in the oropharynx disappear 1 to 2 days earlier.

 Examples of specific applications of the proposed method.

 Extract from the medical history N 2067.

 Patient A.M., 6 years old, was hospitalized from 08/05/94 to 09/06/94 with a diagnosis of toxic oropharyngeal diphtheria of the II degree - in the intensive care unit and intensive care. The child was admitted on the 1st day of the disease in serious condition, which continued to deteriorate despite conventional treatment, including the introduction of antitoxic antidiphtheria serum and detoxification by the introduction of infusion solutions. On the 2nd, 3rd and 4th day of the disease, an ozonized 5% glucose solution of 150 ml was administered iv. By the 7th day of the disease, symptoms of intoxication disappeared. The developed myocarditis proceeded in moderate form. Discharged from hospital in satisfactory condition.

 Extract from the medical history N 3299.

 Patient M.I. For 12 years she was hospitalized in the intensive care unit and intensive care unit with a diagnosis of toxic oropharyngeal diphtheria of the II degree. Concomitant diagnosis: atopic dermatitis, from 8/12/94 to 4/01/95, the girl was admitted on the 2nd day of illness in serious condition. In complex therapy, on the 3rd and 5th day of the disease, 150 ml of an ozonized 5% glucose solution was administered. Discharged from the hospital in satisfactory condition, complications did not develop.

 Extract from the medical history N 607.

 Patient M.N., 6 years old, was admitted to the intensive care unit 04/20/95 g, day 3 of the disease in serious condition. Upon admission, the diagnosis was made: toxic diphtheria of the oropharynx of the III degree. On the 3rd, 6th, 8th day of the disease, an ozonized 5% glucose solution was administered in an amount of 150 ml. Despite the pronounced severity of the disease, complications did not develop. The patient was discharged from the hospital on 05.16.95 in a satisfactory condition.

 As can be seen from the obtained data, the proposed method can effectively treat patients with severe disease.

 In addition, it allows you to treat patients with developing carditis, without exacerbating its development, as well as to eliminate the side effects of blood substitutes.

Sources of information
1. Ostreykov I.F., Matrenitskaya N.A. Plasmapheresis in the complex treatment of toxic diphtheria in children. Anesthesiology and Intensive Care, 1992, N 3, p. 65 - 67.

 2. Favorova L. A., Astafieva N.V., Korzhankova M.P. et al. Diphtheria, M .: Medicine, 1988.

Claims (2)

 1. A method of treating toxic diphtheria by detoxification infusion therapy, comprising administering parenterally a solution of glucose, saline solutions, protein preparations of blood in combination with complex therapy, characterized in that ozone is additionally added, saturating part of one of the injected solutions.  2. The method according to claim 1, characterized in that ozone is saturated with part of the glucose solution, which is 15-20% of the total number of infusion solutions, and the glucose solution contains ozone in an amount of 40-60 μg / L.

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