[Correction of the antioxidative system during ozone therapy in peritonitis].

Clinical studies revealed correlation of changes in anti-oxidative system and lipid peroxidation with peritonitis phases. The assessment of anti-oxidative system was used as an additional diagnostic and prognostic criterion for the disease. Data are presented in proof of efficiency of an ozone physiological solution included in combined treatment of acute peritonitis. Ozone therapy helped to normalize functioning of the anti-oxidative defensive system and thereby decrease the incidence of severe complications and fatal cases among patients with peritonitis.

[Status of the kallikrein-kinin systems and level of antiproteinase potential during postoperative treatment of various forms of peritonitis]. / Sostoianie kallikrein-kininovoi sistemy i uroven' antiproteinaznogo potentsiala pri posleoperatsionnom lechenii razlichnykh form peritonita.

Some parameters of the kallikrein-kinin system and the antiproteinase potential were studied in patients with diffuse peritonitis during the routine treatment course, after additional intramuscular administration of mexidol (inhibitor of free radical oxidation with antiproteinase activity) as well as after treatment of the patients with physiological solution containing ozone (4-7 mg/l used as a donor of free radicals), which was applied for washing of abdominal cavity in one group of patients during surgical operation and for intravenous administration in the other group. The kallikreinkinin system parameters were distinctly altered in the patients with peritonitis and the rate of the system activation correlated with the disease severity. Content of the alpha 1-inhibitor of proteinases (alpha 1-PI) was increased by the middle period of the treatment course and decreased as the inflammation lowered. alpha 2-Macroglobulin (alpha 2-MG) was altered less distinctly as compared with alpha 1-PI. Patterns of the antiproteinase potential in blood plasma (alpha 1-PI and alpha 2-MG) may be used for diagnostic and prognostic purposes in post-surgical treatment of patients with diffuse peritonitis; a decrease in the potential value proved to be a symptom of danger. Both mexidole and ozone exhibited positive clinical effect in treatment of the disease. Although these drugs had an opposing effect on the proteinases activity, their similar action on the antiproteinase potential appears to be responsible for the medicinal efficiency. Clinical effect of the drugs may be arranged as follows: mexidole, ozone administered intravenously and ozone used for intraabdominal washing.

[The antibacterial and immunocorrective action of ozone therapy in peritonitis]. / Antibakterial'noe i immunokorrigiruiushchee deistvie ozonoterapii pri peritonite.

Ozone therapy was used in 74 patients with diffuse forms of purulent peritonitis. It allowed to make postoperative lethality 1.7 times less and the amount of complications 1.8 times less as compared with a group of 62 patients where ozone was not used.

[The prognostic significance of the level of the blood antiproteinase potential in peritonitis]. / Prognosticheskoe znachenie urovnia antiproteinaznogo potentsiala krovi pri peritonite.

It was shown that the level of proteinase alpha 1-inhibitor (alpha 1-i.p.) in the toxic phase of peritonitis was reduced. In transition of the toxic phase to the terminal one the level of alpha 1-i.p. increases which suggests the preserved function of the liver. The terminal phase proper is accompanied by a considerably decreased level of the inhibitor. For this phase proteinase inhibitors should be administered. The level of activity of alpha 1-i.p. can serve as a prognostic criterion of the peritonitis course.

[The use of ultraviolet-irradiated plasma in the treatment of peritonitis]. / Primenenie UF-obluchennoi plazmy v lechenii peritonita.

Intravenous infusion of the one-group lyophilized donor plasma irradiated with ultraviolet rays was included in the complex treatment of 43 patients with acute purulent peritonitis. The species-specific composition of the microflora was studied in the different groups of patients according to the cause of peritonitis and the degree of microbial contamination of the purulent wounds in patients treated with and without ultraviolet plasma irradiation (UVPI). For prognosticating the course and outcome of the disease the authors used a complex of indices linked with the manifestation of neutrophil bactericidal activity and the level of exogenous intoxication. A positive effect of UVPI in the management of acute purulent appendicitis was noted, which was confirmed by clinical and microbiological tests.

[Use of ribonuclease in multimodal treatment of acute pancreatitis]. / Primenenie ribonuklezy v kompleksnom lechenii ostrogo pankreatita.

The method of intraductal administration of ribonuclease as a therapeutic measure was developed on an experimental model of acute pancreatitis in albino rats. Morphological and biochemical examination showed that intraductal administration of ribonuclease in a dose of 0.5 mg produces a positive therapeutic effect, which allowed the method to be applied in complex treatment of 33 patients with various forms of acute pancreatitis. Administration of ribonuclease into the pancreatic duct relieved the attack of pain and reduced the level of lipo- and proteolytic enzymes in blood. No complications were encountered in endoscopic cannulation of the main pancreatic duct and subsequent administration of ribonuclease.

[Results of the treatment of patients with torsion of the sigmoid]. / Rezul'taty lecheniia bol'nykh s zavorotom sigmovidnoi kishki.

The results of treatment of 204 patients with torsion of the sigmoid colon are analysed. Total postoperative mortality was 14.2%. Sixty-eight patients were subjected to palliative operations of the type of ++de-torsion or ++de-torsion in combination with mesosigmoplication and sigmopexy. In this group of patients, 20.5% underwent a second operation for a recurrence of the disease in different periods after the first operation. The mortality rate after palliative operations was 13.2%. Resection of the sigmoid colon with an end-to-end anastomosis was carried out in 87 patients. The postoperative mortality was 13.7%. There were no fatal outcomes among patients who were treated by radical operation carried out in a planned order of preliminary detorsion. In 11.7% of cases, sigmoid torsion was complicated by gangrene. Seven patients (29.1%) died in the postoperative period.