UA143577U - APPLICATION OF REOSORBILACT INFUSION DRUG AS A MEANS FOR NORMALIZATION OF WATER-ELECTROLYTE EXCHANGE IN SURGERY PATTERNS OF CANCER CANCER - Google Patents

Abstract

The use of the infusion drug Reosorbilakt as a means to normalize water-electrolyte metabolism in operated patients with rectal cancer after anterior resection of the rectum.

Description

The useful model belongs to the field of medicine, namely, it concerns the use of the infusional complex drug Reosorbilact of polyfunctional action to normalize water-electrolyte exchange in order to prevent postoperative complications in operated on patients with rectal cancer after anterior rectal resection in the early postoperative period.

The relevance of the subject of the useful model is associated with the growth of the incidence of rectal cancer and the increase in the number of anterior rectal resection operations.

Oncology patients with rectal cancer with total lesions, exhausted by the disease and impaired metabolism, who underwent anterior rectal resection, which causes operative stress, develop water-electrolyte metabolism disorders, which worsen the course of the early postoperative period and lead to complications.

The use of the complex infusion drug Reosorbilact of polyfunctional action to normalize water-electrolyte exchange in order to prevent postoperative complications in operated patients in the early postoperative period is relevant and necessary in the surgical treatment of patients with rectal cancer after anterior rectal resection.

Ringer-Locke solution for intravenous infusions of 800.0 milliliters per day was used as a comparison drug. Composition of Ringer-Locke solution: sodium chloride - 9.0 g; sodium bicarbonate - 0.2 g, calcium chloride - 0.2 g, potassium chloride - 0.2 g, glucose - 1.0 g, water for injections up to 1 liter.

Unlike Ringer-Locke solution, Reosorbilact contains sodium lactate, an alkalizing agent, which has the ability to normalize the acid-base state of the body. Unlike sodium bicarbonate solution, the correction of metabolic acidosis occurs gradually, as sodium lactate is incorporated into the metabolism, without causing significant fluctuations in the hydrogen indicator (hydrogen ion activity - pH).

The complex infusion drug Reosorbilact with multifunctional action was created and developed at the State Institution "Institute of Blood Pathology and Transfusion Medicine

of the National Academy of Medical Sciences of Ukraine", Lviv.

The purpose of the useful model is to increase the effectiveness of surgical treatment of oncological patients with rectal cancer after anterior rectal resection in the early

In the postoperative period, improvement of the immediate results of surgical treatment, reduction of the number of postoperative complications, reduction of the duration of treatment of operated patients, reduction of the number of bed days.

The task is solved by the fact that in oncological patients with rectal cancer, immediately after the operation of anterior rectal resection, a complex drug is used

Rheosorbilact of multifunctional action 800.0 ml per day at a rate of 40 drops per minute for 5 days.

Reosorbilact - an infusion preparation, the components are: sorbitol - 60.0 g, sodium lactate - 19.0 g, sodium chloride - 6.0 g, calcium chloride - 0.1 g, potassium chloride - 0.3 g, magnesium chloride - 0.2 g, water for injections up to 1.0 liters.

Ionic composition of the drug: sodium ion - 6.395 mg/ml - 278.16 mmol/l; potassium ion - 0.157 mg/ml - 4.02 mmol/l; calcium ion - 0.036 mg/ml - 0.90 mmol/l; magnesium ion - 0.051 mg/ml - 2.10 mmol/l; chlorine ion - 3.995 mg/ml - 112.69 mmol/l; lactate ion - 15.635 mg/ml - 175.52 mmol/l; pH - 6.0-7.5.

Reosorbilact is a clear liquid in bottles of 200.0 and 400.0 ml.

The instructions for the medical use of Reosorbilact were approved by the order of the Ministry of Health

Mo 629 of Ukraine dated 21.03.2019, registration certificate Me SHA/2399/01/01.

In oncological patients, in order to establish a clinical diagnosis, in addition to x-ray examination of the digestive tract, a colonoscopy of the rectus, sigmoid, lumbar and colon with tumor biopsy was performed, as well as a computer examination of the abdominal organs.

To establish the clinical effectiveness of the use of the infusion drug Reosorbilact in patients with rectal cancer after anterior rectal resection in the early postoperative period, two groups of oncological patients were examined according to their clinical diagnosis, gender and age (Table 1).

Table 1

Distribution of cancer patients by clinical diagnosis, sex and age of patients

Rectal cancer 57 |From |21|4|3 1710 4 | 58 | 5 | with (Total cancer patients | 57 | With |2|4|3/|/104|5|8 | 5 | with

57 oncological patients with rectal cancer were under clinical observation. Among the operated - 37 men and 20 women. Age of patients: from 41 to 50 years - 5, from 51 to 60 years - 7, from 61 to 70 years - 14, from 71 to 80 years - 23, from 81 to 90 years - 8 (see table 1).

The method and volume of anterior rectal resection was determined depending on the localization, spread and growth form of the malignant process, detected before and during operations.

The types and nature of surgical interventions are presented in Table 2.

Table 2

Operative interventions in oncological patients with rectal cancer who received infusions of Reosorbilact (main group) and Ringer-Locke solution (comparison group)

Clinical diagnosis Number of patients Operations no operations

The main group - 30 oncological patients with rectal cancer after anterior rectal resection received infusion therapy using the drug Reosorbilact in a dose of 800.0 ml per day at a rate of 40 drops per minute for 5 days in the early postoperative period.

The comparison group - 27 oncological patients with rectal cancer after anterior rectal resection received infusion therapy with Ringer-Locke solution at a dose of 800.0 ml per day as a drug for comparison.

Studies of the influence of the infusion drug Reosorbilact and Ringer-Locke's solution on the dynamics of indicators of water-electrolyte exchange were carried out before the start of infusion therapy and on the 6th day after the therapy.

In oncological patients with rectal cancer after anterior rectal resection surgery, a decrease in potassium content in blood plasma was found in operated patients in the first days of the early postoperative period. A decrease in the content of potassium in the blood plasma changes the functioning of the membranes of neurons and muscles, which leads to a violation of the conduction and rhythm of cardiac activity, especially in the first days after operations. Operative stress causes a decrease in the assimilation of potassium by the cells of the operated organism.

Infusion therapy with the use of the complex drug Reosorbilact of multifunctional action in a dose of 800.0 ml per day immediately after operations for 5 days leads to the normalization of the concentration of potassium in the blood plasma in operated patients with rectal cancer after anterior rectal resection in the early postoperative period ( table 3).

Normalization of potassium in operated patients is determined by the composition of the infusion drug

Reosorbilact - potassium ions are 0.157 mg/ml - 4.02 mmol/l.

Thus, it was established that in the main group of oncological patients with rectal cancer after anterior resection of the rectum up to the 6th day of infusion therapy with the drug Reosorbilact normalization of potassium in blood plasma is observed in operated patients.

In the comparison group, on the 6th day, the tendency to increase the content of potassium in the blood plasma was restored, but it was significantly less than in the main group. Normalization of potassium occurred after 9 days during infusion therapy with Ringer-Locke solution.

Therefore, the use of the infusion drug Reosorbilact of polyfunctional action helps to accelerate the normalization of the potassium content of the blood plasma on the 6th day in the early postoperative period in comparison with Ringer-Locke solution infusions.

In oncological patients with rectal cancer after anterior rectal resection in the first days of the early postoperative period, a decrease in sodium content in the blood plasma was found. A decrease in sodium in the blood leads to the retention of water in tissue cells, resulting in swelling. In operated patients, the amount of water in the blood plasma decreases, which leads to thickening of the blood, increase in its viscosity, and impaired blood supply to the kidneys.

Table C

The influence of the infusion drug Reosorbilact and Ringer-Locke solution on indicators of water-electrolyte exchange in operated patients with rectal cancer after anterior resection of the rectum (Mat) o (no metabolism, units of measurement Reosorbilact p-30 | Ringer-Locke p-27

Intravenous infusions of the complex drug Reosorbilact with polyfunctional action at a dose of 800.0 ml per day for 5 days lead to the normalization of sodium concentration in the blood plasma of operated patients (see table Mo 3). Sodium participates in the processes of distribution and removal of water, in maintaining osmotic pressure in operated patients in the early postoperative period.

The normalization of sodium content in operated patients is caused by the presence of sodium ions - 6.395 mg/ml - 218.16 mmol/l in the complex drug Reosorbilact.

Thus, it was established that in the main group of oncological patients with rectal cancer, after anterior rectal resection, normalization of the concentration of sodium in the blood plasma of operated patients is observed up to the 6th day.

In the comparison group, on the 6th day, the tendency to decrease the concentration of sodium in the blood plasma resumed, but it was significantly less than in the main group. Normalization of blood sodium concentration occurred after 9 days during infusion therapy with Ringer-Locke solution.

Therefore, the use of complex infusion drug Reosorbilact with polyfunctional action in oncological patients with rectal cancer after anterior rectal resection helps to accelerate the normalization of sodium concentration in the blood plasma on the 6th day after complex proctological surgery in comparison with Ringer-Locke solution.

In oncological patients with rectal cancer, after anterior resection of the rectum, a decrease in calcium content in the blood plasma was found, which is caused by operative stress in operated patients in the first days of the early postoperative period.

The use of the complex infusion drug Reosorbilact of multifunctional action immediately after operations in the form of intravenous drip infusions of 800.0 ml per day at a rate of 40 drops per minute for 5 days leads to the normalization of the concentration of calcium in the blood plasma of operated patients (see table Mo 3 ). The normalization of the calcium content in the blood plasma is due to the presence of calcium ions in the infusion drug Reosorbilact - 0.036 mg/ml - 0.90 mmol/l.

Thus, it was established that in the main group of cancer patients with rectal cancer after

From the anterior resection of the rectum to the 6th day, normalization of calcium in the blood plasma of the operated patients is observed.

In the comparison group, on the 6th day, the tendency towards normalization of calcium in the blood of cancer patients resumed, but it was significantly less than in the main group. Normalization of calcium in blood plasma occurred after 9 days during infusion therapy with Ringer-Locke solution.

So, it was established that in the main group of oncological patients with rectal cancer, after anterior resection of the rectum, up to the 6th day of infusion therapy with the drug Reosorbilact, normalization of indicators of water-electrolyte exchange in operated patients is observed.

In the comparison group, on the 6th day, the tendency to improve indicators of water-electrolyte exchange resumed, but it was significantly lower than in the main group, the content of potassium, sodium, calcium in the blood plasma differed significantly from the main group. Normalization of electrolyte indicators occurred after 9 days during infusion therapy using Ringer-Locke solution (see Table 3).

Therefore, the use of intravenous infusions of the drug Reosorbilact helps to accelerate the normalization of the concentration of potassium, sodium, and calcium in the blood plasma in oncological patients with rectal cancer on the 6th day after anterior rectal resection compared to infusions with a solution

Ringer-Locke. The obtained data claim that the use of the drug Reosorbilact has significant advantages over the Ringer-Locke solution - the prototype, as it accelerates the normalization of the content of potassium, sodium, calcium in the blood plasma of operated patients, which confirms the essence of the task of a useful model.

The therapeutic effectiveness of the Reosorbilact infusion drug is due to its detoxifying, energetic, intestinal motility-stimulating action and acid-base correction.

So, on the second day, after the infusion therapy with the drug

Reosorbilact has a pronounced clinical effect. In oncological patients with rectal cancer after anterior rectal resection who received intravenous infusions of the drug

Reosorbilact earlier restores the functions of the gastrointestinal tract, heals wounds by primary tension, significantly reduces the number of postoperative complications, operated patients on the 3rd day are discharged from the clinic sooner.

In the comparison group, there was a trend toward improvement in clinical signs on day 6, but significantly less than in the main group. An oncological patient with rectal cancer developed signs of an inflammatory process of intestinal anastomosis after anterior rectal resection.

The obtained data confirm that the use of the infusion drug Reosorbilact has significant advantages over the prototype Ringer-Locke solution, as there is an acceleration of the normalization of clinical signs in the early postoperative period, which significantly reduces the number of postoperative complications and confirms the essence of the task of a useful model.

A specific example of the use of the infusion drug Reosorbilact in an oncological patient with rectal cancer:

Min. K., male, 78 years old, diagnosed with rectal cancer. A complex proctological operation was performed on an oncological patient - anterior resection of the rectum. Immediately after the operation, the patient was prescribed an intravenous drip of the drug Reosorbilact in a dose of 800.0 ml per day at a rate of 40 drops per minute for 5 days.

Infusion therapy with the use of the drug Reosorbilact led to an improvement in the general condition of the operated patient, normalization of the content of potassium, sodium, calcium in the blood plasma of the operated patient. Intestinal peristalsis was restored before the end of the 2-0th day after the operation. The patient's wound healed with primary tension. The condition of the operated patient improved and he was discharged from the clinic in satisfactory condition on the 3rd day sooner than in the comparison group.

Since, when using the infusion drug Reosorbilact, the length of stay of operated patients in inpatient treatment is shortened, thanks to accelerated normalization

From indicators of water-electrolyte exchange, which improves the immediate results of surgical treatment and prevents the occurrence of postoperative complications, the use of the drug

Reosorbilact is useful and necessary for practical medicine.

Infusion therapy with the drug Reosorbilact has a positive clinical effect, which is expressed in the restoration of peristalsis of the gastrointestinal tract on the 2nd day after surgery.

Wounds heal more quickly with primary tension. In operated patients, inflammatory edema of the intestinal anastomosis does not develop.

Therefore, the use of the complex infusion drug Reosorbilact of polyfunctional action to normalize the water-electrolyte exchange in operated patients with rectal cancer after anterior rectal resection allows to reduce the duration of treatment of oncological patients in the early postoperative period, since the immediate results of surgical treatment are improved when using the drug, which is significant reduces the number of postoperative complications and leads to a reduction in the length of stay of operated patients in the clinic on the 3rd day, which confirms the implementation of the task of a useful model.

The use of the infusion drug Reosorbilact is characterized by good tolerance and the absence of side effects. Infusion therapy does not require expensive drugs, the goal is based on the use of the domestic drug Reosorbilact, which is available in sufficient quantities in pharmacies of Ukraine at an affordable price. The use of the drug Reosorbilact is useful and necessary in medical practice for wide use in infusion therapy of operated patients in intensive care, proctological, abdominal and surgical departments of clinics and hospitals.

Claims (1)

USEFUL MODEL FORMULA Use of the infusion drug Reosorbilact as a means to normalize water-electrolyte exchange in operated patients with rectal cancer after anterior rectal resection INTESTINES.