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Антиэндотоксиновая составляющая в профилактике послеоперационных осложнений у детей с обструктивной уропатией

Антиэндотоксиновая составляющая в профилактике послеоперационных осложнений у детей с обструктивной уропатией

Abstract

Чтобы подтвердить предположение о возможности профилактики послеоперационных осложнений, в частности послеоперационной макрогематурии, путем снижения уровня кишечного эндотоксина в общем кровотоке, 27 детям (1-я группа) в возрасте от 5 мес до 12 лет с обструктивной уропатией (гидронефроз, уретерогидронефроз и пузырно-мочеточниковый рефлюкс) за 3 нед до операции была проведена предоперационная подготовка, которая включала применение энтеросгеля, хофитола, бифидумбактерина в возрастных дозировках. Во 2-ю группу (контрольную) вошли 37 детей такого же возраста с такой же патологией. Показатели эндотоксина, антиэндотоксинового иммунитета и гемостаза определяли у всех детей до и после операции с помощью Микро-ЛАЛ-теста (E-toxate фирмы “Sigma"), адаптированного к клинике, скрининговой диагностической тест-системы “СОИС-ИФА" и электрокоагулографа Н-334. Сравнительный анализ результатов показал, что антиэндотоксиновая составляющая предоперационной подготовки является эффективным средством профилактики послеоперационных осложнений у детей с обструктивными уропатиями. Ее применение в 1,5 раза снизило частоту послеоперационной макрогематурии, увеличило частоту более легких форм последней. Это служит мотивацией к поиску новых и более эффективных средств снижения уровня кишечного эндотоксина в общей гемоциркуляции.A group of 27 children aged from 5 months to 12 years with obstructive uropathy (hydronephrosis, uretherohydronephrosis, vesicoureteral reflux) underwent preoperative preparation with the use of enterosgel, chofitol, and bifudumbacterin 3 weeks before surgery. The control group was comprised of 37 children matched for age and pathology. Endotoxin levels, characteristics of antiendotoxin immunity and hemostasis were determindprior to surgery using the micro-LAL test (E-toxate, Sigma) adapted to clinical application, the screening immunoassay system for the assessment of immune status, and a H-334 electrocoagulograph. Comparative analysis of the results showed that the antiendotoxic component of preoperative preparation is an efficacious tool for the prevention of postoperative complications in children with obstructive uropathy. It decreases the frequency of postoperative macrohematuria by 1.5 times and increases percentage of its mild forms. Hence, motivation to search for new and more effective means for reducing intestinal endotoxin levels in systemic circulation.

Keywords

ОБСТРУКТИВНЫЕ УРОПАТИИ, ПОСЛЕОПЕРАЦИОННАЯ МАКРОГЕМАТУРИЯ, ЭНДОТОКСИН, ПРОФИЛАКТИКА

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold