[Disorders of immune status in duodenal ulcer complicated by perforation and peritonitis]. / Narushenie immunnogo statusa pri iazvennoi bolezni dvenadtsatiperstnoi kishki, oslozhnënnoi perforatsiei i peritonitom.

The chemotaxic activity of neutrophil granulocytes was studied in 112 patients with duodenal ulcer disease complicated by perforation and peritonitis with a different degree of spreading. Sharp decrease in spontaneous migration of leukocytes (SML) was revealed in generalized peritonitis. In diffuse peritonitis, the index didn't differ from that in normal subjects. In patients with the complicated course of the postoperative period, SML stimulation under the influence of the own serum was noted. At day 3-9 after the operation, the stimulating activity of the humoral factors of immunity was gradually decreasing. Use of the stimulators of migrative activity of phagocytes contributes to normalization of their function. In patients who had the immunocorrigative agents been prescribed, aggravation of peritonitis and purulent-septic complications were noted 1.4-fold less often than in absence of such treatment.

[Prevention of early inflammatory complications after transthoracic interventions and estimation of the degree of immunologic deficiency]. / Profilaktika rannikh vospalitel'nykh oslozhnenii posle trans- torakal'nykh vmeshatel'stv s uchetom vyrazhennosti immunodefitsita.

An analysis of the results of the examination and treatment of 379 patients undergoing transthoracic interventions showed that the use of the target-aimed selective immunomodulation, short-term antibacterial prophylaxis, inhibitors of arachidonic acid metabolites, active elimination of the circulating immune complexes and medium-weight molecular peptides and adequate local analgesia after the interventions providing normalization of the laryngeal reflex and early activation of the patients permitted the incidence of the pulmonary complications to be decreased by 2.5 times, pleural complications by 1.7 times, suppuration of the postoperative wound by 1.8 times and the total expenses by 25.6 per cent.

[Use of external drainage of the thoracic duct and lymphosorption in the complex treatment of acute diffuse peritonitis]. / Primenenie naruzhnogo drenirovaniia grudnogo protoka i limfosorbtsii v kompleksnom lechenii ostrogo razlitogo peritonita.

In 47 patients with acute generalized peritonitis in the complex of therapeutic measures, the external drainage of the thoracic duct (EDTD) with subsequent lymphosorption (LS) was used. The effectiveness of treatment was judged about by the lymph and blood toxicity, and as well by contents of peptides with the molecular mass of from 300 to 1000 dalton. In favourable course of the postoperative period, the increase in lymph debit and decrease in proteolytic enzyme activity in the lymph and blood were noted. The use of EDTD and LS in the complex with the other methods of treatment permitted to achieve a clinical effect in 76.6% of cases.

[Disorders of immunoreactivity in acute cholecystitis in middle-aged and elderly patients and their correction in preventing postoperative complications]. / Narusheniia immunoreaktivnosti pri ostrom kholetsistite u bol'nykh pozhilogo i starcheskogo vozrasta i ikh korrektsiia v profilatike posleoperatsionnykh oslozhnenii.

In elderly and senile patients with acute cholecystitis, the decrease in the content of T-lymphocytes and their functional activity, number of B-lymphocytes and IgG level, increase in the IgM and IgA content were noted. The attenuation of non-specific protective mechanisms was revealed. In patients, who underwent the purposeful immunocorrection with prodigiosan, proper-myl, methyluracil and staphylococcal adsorbed anatoxin, the number and activity of T-lymphocytes normalized, number of B-lymphocytes increased at the time of operation and after it. This contributed to reduction of the incidence of the inflammatory complications 3-fold.