ABSTRACT
Twenty-nine patients undergoing cholecystectomy because of chronic calculous cholecystitis were randomised to receive phenylbutazone 10 mg/kg intramuscularly or a control injection (vehicle-containing local anaesthetic) immediately after completion of surgery. Fibrinogen and plasminogen concentrations in plasma, plasminogen activator inhibitor activity in plasma and fibrinolytic activity in concentrated euglobulins were determined before surgery and on the first, third and seventh postoperative days. Phenylbutazone delayed the postoperative rise of fibrinogen concentration and reduced the plasminogen level on the first day after surgery. Fibrinolytic activity in euglobulins was decreased after the operation in both groups. The great dispersion of the results of plasminogen activator inhibitor activity was the plausible cause of the lack of any significant difference in this variable. The postoperative fibrinolytic shutdown, reflected by the decrease of fibrinolytic activity, was unaffected by phenylbutazone. It can be speculated, however, that the decline of plasminogen concentration after surgery in patients receiving this drug was the result of its stimulatory influence on the conversion of plasminogen into plasmin.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Fibrinolysis/drug effects , Phenylbutazone/pharmacology , Cholecystectomy , Female , Fibrinogen/analysis , Humans , Injections, Intramuscular , Male , Middle Aged , Plasminogen/analysis , Plasminogen Inactivators/blood , Postoperative PeriodABSTRACT
A group of 133 patients treated for bleeding peptic ulcer in our Department, is reviewed. Within several hours of admission, all patients underwent upper gastrointestinal tract gastroscopy and obliteration of the bleeding ulcer. Bleeding gastric ulcers were found in 41 patients, and duodenal ulcers in 92 patients. Patients were classified according to the Forrest scale: IA - 11 patients, IB - 49 patients, IIA - 35 patients, lIB - 40 patients. In 126 (94.7%) patients the bleeding was stopped, and 7 required urgent surgery: 3 patients with gastric ulcer underwent gastrectomy, and 4 with duodenal ulcer - truncal vagotomy with pyloroplasty and had the bleeding site underpinned. Fifty-five patients underwent elective surgery: gastrectomy and vagotomy (18 patients with gastric ulcer), highly selective vagotomy (25 patients with duodenal ulcer) and truncal vagotomy and pyloroplasty (12 patients with duodenal ulcer). None of the patients was observed to have recurrent bleeding.
