SU1311710A1 - Method of treatment of acute postoperational pancreatitis - Google Patents

Abstract

METHOD OF TREATMENT FOR ACUTE POSTOPERNATIONAL PANCREATITIS

To reduce the duration of treatment after the single-dose administration of drugs after 20 minutes, a reopolyglucine-complamine-trent mixture is administered intravenously at doses of 10-12, 8-9, 3-4 mg / kg of body weight 2 times a day at a rate of 40-60 drops in 1 minute to normalize amylase in the blood and urine, table 2. (L from 00

Description

1ME

The invention relates to medicine, namely to surgery of the digestive system,

The purpose of the invention is to reduce the duration of treatment by means of drug-induced tera-FDI, which improves blood microcirculation and increases the volume of circulating plasma.

The method is carried out as follows.

After simultaneous administration of contrycal, novocaine, 5-fluorouracil, in 20-30 minutes, the reopolyglucine-complamine-trental mixture is administered intravenously in doses of 10–12, 8–9, 3-4 mg / kg of body weight, 2 times a day, respectively. at a rate of 40- 60 drops in 1 min. until normalization of amylase in the blood and urine.

The presence in the blood or urine of an increased content of the enzyme amylase, as a rule, indicates involvement in the pathological process of the pancreas, which is an indication for therapeutic measures,

Example, Patient G, 42 years old, was admitted to the hospital with a diagnosis of chronic recurrent calculous cholecystitis,

The operation of cholecystectomy, drainage of the common bile duct according to Halstead, was performed. After 24 hours the postoperative period was complicated by acute postoperative pancreatitis with an increase in serum amylase level to 135 g (h, l). The postoperative therapy was supplemented with the introduction of 80 thousand units of contryla and 20 minutes later, its administration intravenously at a speed of 40- 60 drops in 1 minute was administered by the reopolyglucin-complamine-trental mixture. Taking into account the patient's mass of 67 kg, 700 ml of rheopolyglucin, 600 mg of complamine and 200 mg of trental are administered. The mixture is administered 2 times per day. The course of therapy 3 days. Blood counts before and after prophylaxis are presented in Table 1,

Table 1

Viscosity at 10, cP

13.8

8.2

ten

Continued table.

Viscosity at

100, 55.7

Hematocrit,% 54 45

Fibronogen concentration

µmol / l

Fibrinogen b

4.6 2.5 +3 (+ +) +1 (+)

Prothrombin

% 95 72

Spontaneous aggregation, score 16.4 6.7

Thromboelastography:

reaction time

R, min 3 7,4

clot formation time K, min 2 4.7

maximum

amplitude goa

mm 63 55

content

amylase in the blood,

g (h, l,) 135 25

As can be seen from Table 1, after taking measures to prevent microcirculation disorders, a significant improvement in peripheral perfusion, tissue blood flow, hemorheological indicators was found. A significant increase in the number of functioning capillaries was found in the system of peripheral microcirculation. ditch, reduction of vasoconstriction, erythrocyte disaggregation mainly in the capacitive regions of the microvasculature. At the same time, the conjunctive indicator decreased from 9.7 t 0.65 to 6.78 ± 0.47 points (, 05).

An improvement in the rheological characteristics is indicated by a decrease in the aggregation rate of erythrocytes from 14.310.63 to 9.7 / tO, 27 points (P 0.02), - Po313 improved significantly

The viscosity indexes are coovi and the content of amylase in the blood and urine has decreased to a normal level.

After 14 days, the patient was discharged in good condition.

Example 2. Patient X, 51 years old, was admitted to the hospital with a diagnosis of duodenal ulcer disease, complicated by stenosis. Produced selective vagotomy, resection of the antrum of the stomach according to B. - P. Hofmeister-Finchester.

Six hours after the operation, an increase in the serum amylase level in the blood serum to 94.3 g (tsp) was noted in the patient's blood. Postoperative infusion therapy was supplemented with intravenous administration of 60 thousand units. contraic, and 30 minutes after its introduction, the reopolyglucine-complamin-trent mixture, which is administered 2 times a day at a rate of 40-60 drops per minute. Taking into account the weight of the patient 75 kg. The disaggregate mixture consisted of 800 ml of reopiglucine, 600 mg of complamine and 300 mg of trental. Prevention course 2 days. Blood counts before and after prophylaxis are given in table. 2..

Table 2

13,37,4

13.7 6.1

11.6 6.1 53 44

Fibrinogen b

+ 3 (+ - +) norm

105 72

14, 5 7, -1 55

ten

Continued table. 2

1.5

50

68

94

120

8.1

228

55

21

80

All indicators indicate a high efficacy of the treatment method. The patient on day 12 after surgery was discharged in good condition.

Thus, the additional administration of the reopolyglucine-complamin-trental mixture prevents the aggregation of blood cells due to a decrease in its viscosity and an increase in the elasticity of red blood cells, thus improving microcirculation of the blood. In addition, the addition of the above drug mixture activates the adsorption of mixture molecules on blood cells, increasing their electronegativity, which contributes to the creation of high colloid-osmotic pressure, thereby increasing the volume of circulating plasma. The treatment time of the proposed method is reduced by 3-5 days as compared with the known.

Claims (1)

Invention Formula A method of treating acute postoperative pancreatitis by administering drugs, characterized in that, in order to shorten the duration of treatment, after 20-30 minutes, 2 times a day, intravenous reopolyglucine-comminant-throne mixture is administered in therapeutic doses at a rate of 40-60 drops in 1 min