RESUMO
THE AIM: To study the efficiency of enteral nutritional support and its impact on clinical-laboratorial markers of hepatocellular failure of the patients with Child-Pue's hepatic cirrhosis type B suffering from trafologic impairment. MATERIAL AND RESEARCH METHODS: 61 patients with Child-Pue's hepatic cirrhosis type B suffering from trafologic impairment took part in the randomized prospective study. The control group (31 patients) got the conventional treatment with lactulose, beta-blocker, spironolactone on the basis of 1.2 g/kg protein weight and 30 kcal/kg body weight per day. There were 30 patients in the second group (the principal one) and in addition to conventional treatment they got the multisubstrate nutritional cocktail of dietary fibers on the basis of 0.3 g/kg protein weight, 7.5 g fibers per day and 10 kcal/kg body weight during 30 days. To evaluate the efficiency of the treatment we analyzed the clinical presentation and the intensity of blood cholinesterase. The stage of hepatic encephalopathy was defined with the affinity numbers test of Retainer. The parameters under study were checked before the treatment, 30 days and 60 days later after the treatment began. RESULTS: It was found out during the prospective randomized study that the patients under nutritional support showed the positive clinical dynamics (asthenia and hepatic encephalopathy retrogression and the accurate increase of blood cholinesterase from 4365.4 +/- 1028.6 ME up to 5502.7 +/- 1142.6 ME (p < 0.05). CONCLUSION: Nutritional support of the patients with Child-Pue's hepatic cirrhosis type B suffering from trafologic impairment is effective and has an accurate impact upon clinical-laboratorial markers of hepatocellular failure.
Assuntos
Nutrição Enteral/métodos , Insuficiência Hepática/prevenção & controle , Cirrose Hepática/terapia , Astenia/etiologia , Astenia/prevenção & controle , Colinesterases/sangue , Fibras na Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Feminino , Encefalopatia Hepática/etiologia , Encefalopatia Hepática/prevenção & controle , Insuficiência Hepática/enzimologia , Insuficiência Hepática/etiologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/enzimologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Estudos Prospectivos , Resultado do TratamentoRESUMO
Programmed computer transesophageal pacing with pharmacological heart denervation by A. Jose and D. Collinson, mathematical analysis of cardiac rhythm according to spectral and statistical methods were used in the study of extra-abdominal (cardial and vegetative) manifestations of dumping syndrome (DS)--one of severe complications of ulcer surgery. Serotoninemia was assessed by enzyme immunoassay (DRG kit). It was established that cardial and vegetative disorders are typical for DS patients and correlate with severity of motor defects of the gastrointestinal zone as well as fasting serotonin levels. Cardiac arrhythmias in DS in most cases are associated with functional insufficiency of pacemakers. This requires caution in administration of antiarrhythmic drugs in DS patients.
