SU1747074A1 - Immunotherapy method - Google Patents

Abstract

The invention relates to medicine, in particular to intensive care and immunology. The goal is to enhance the effect of immunization. This is achieved by conducting extracorporeal blood perfusion through sections of the pork thymus gland. This increases the stimulation of the immune functions of the body, which increases the effect of therapeutic measures in patients with secondary immunodeficiency. 1 tab.

Description

The invention relates to medicine, in particular to surgery, and can be used in the treatment of patients with purulent-septic diseases and secondary immunodeficiency.

The known method of extracorporeal perfusion of blood through the donor, pork spleen.

The disadvantages of this method are: the possibility of complications associated with blood loss during blood perfusion through the spleen, and an insufficient range of immunomodulating functions of the spleen.

There is also known a method of detoxification, an organism for purulent-septic diseases, including perfusion of blood through sections of the spleen placed in a sterile chamber.

The disadvantage of this method is the insufficient spectrum of immunomodulating functions of the spleen.

The purpose of the invention is to enhance the effect of immunostimulation.

The goal is achieved by the extracorporeal perfusion of blood through sections of the thymus pigs.

The method is carried out as follows.

Immediately after the animal was slaughtered, the sternum together with the thymus gland were removed in a sterile condition, placed in a sterile tray with furatsilin 1: 5000 solution, covered with sterile material and delivered in an ice container. Under operating conditions, the gland is separated from the sternum, dissected into sections 2–4 mm thick and placed in a 100 cm sterile chamber. In this form, at room temperature, the gland is washed from the blood in 1000 ml of saline. After extracorporal connection of the chamber with the pig thymus into the patient’s bloodstream, the latter is placed in a thermostat at 37 ° C. Volume velocity is 60-100 ml / min. The duration of perfusion 40- 80 minutes Gelsri-nizaz of the patient with heparin at the rate of 0.25-0.3 thousand units / kg of the patient's weight After the end of the session, the deposited blood

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washed with saline and returned to the patient.

Example 1. Sick T. 51, transferred to the clinic in poor condition, diagnosis: diffuse fibrious-purulent peritonitis, complete small intestinal fistula, extensive putrid necrotic phlegmon of the anterior abdominal wall. Under the conditions of the intensive care unit, intensive infusion detoxification, antibacterial therapy with intra-aortic drug administration was carried out. In order to stimulate the immune and reparative functions of the body, an extracorporal connection of porcine thymus (EKSTT) was conducted. The vilochkova gland is dissected into slices 2-4 mm thick, which are washed and placed in a 100 cm sterile chamber. Lastly, after heparinization, the patient has 10 thousand units of heparin through

the cannula is connected to the great vessels (right and left subclavian veins). The perfusion was carried out using a roller pump for 40 minutes at a rate of 50 ml / min. During the session, hemodynamics is stable (BP 110 / 70-110 / 60, pulse 92). There were no complications. The further course of the disease after EXPST with a clear positive dynamics - the state of health improved, the wound was actively cleansed, covered with granules, which created favorable conditions for the reconstructive surgery. On the 18th day after the operation, she was discharged in a satisfactory condition and was discharged home.

The laboratory parameters of a patient with diffuse fibrin-bearing peritonitis, complete small intestinal fistula, extensive putrefactive necrotic phlegmon of the anterior abdominal wall before, after, 1, 3, 5 days after EKSTT are presented in the table.

PRI mme R 2. Sick C - 52 years old, was admitted to the clinic to close a single-barreled bone. On the third day after the operation of restoring the continuity of the large intestine with an anastomosis of the segmented gut, the temperature to 38 ° C, pain in the abdomen, and the flow of feces through the counterperperture appeared end to side. Diagnosis: inconsistency of sigmo-sigmo anastomosis, local peritonitis, colonic fistula. The treatment is conservative. The lack of success of the combined therapy, against the background of reduced immunity, was the reason for the extracorporeal connection of the xenogenic thymus gland. On the 9th day after the operation, an EKPST session was performed. The Extracorporeal Perfusion System was connected with connected throat through a cannula through a 100-cm chamber with a thymus gland, which had been previously dissected and washed. Heparinization with heparin 15 thousand units The pumping rate of blood in the EKSTT system averaged 65 ml / min. The session lasted 60 minutes; the total volume of blood that passed through the chamber averaged 3.9 liters.

During the session, EKPCT patient felt good, subjectively, she did not notice any adverse events. Throughout the session, hemodynamics was stable. After the ECCPT session, the deposited blood in the chamber was washed out with 200 ml of saline, the patient was returned.

In the following days, the patient's condition improved progressively, the temperature dropped to normal values of 36.5– 36.7 ° C, the intestinal secretion stopped, the wound closed. In a satisfactory condition after 14 days, the patient was discharged home.

The dynamics of changes in the indices of 45 mo-sigmo anastomosis, local peritonitis, after, 1, 3, 5 days after the session, the colonic fistula is given in EKSTT in a patient with inconsistency of sig, table.

Thus, conducting an extracorporal connection session of pig thymus slices is a turning point in the patient's condition, which immediately appears to have a positive dynamics of clinical and laboratory parameters, which is due to the increased immunostimulation effect.

Claims (1)

Invention Formula 50 Method of immunotherapy, including extracorporeal xenoperfusion of blood, characterized in that, in order to enhance the effect of immunostimulation, blood perfusion is performed through 55 pork thymus gland slices.