[Comparative data about cryosupernatant and fresh frozen plasma use in treatment of disseminated intravascular coagulation in patients with generalized peritonitis].

PURPOSE OF THE STUDY: To compare the complex treatment of peritonitis with cryosupernatant and with fresh frozen plasma. MATERIALS AND METHODS: Outcomes of treatment were studied in 88 patients receiving cryosupernatant and in 112 receiving fresh frozen plasma. RESULTS: Cryosupernatant application provides better dynamics of hemostasis, decreases a risk of thrombosis and mortality and improves outcomes of treatment. CONCLUSIONS: Cryosupernatant can be used instead of fresh frozen plasma in complex treatment of disseminated intravascular coagulation in patients with generalized peritonitis.

[Comparison of a medical effect of cryosupernatant and fresh frozen plasma used in complex treatment of patients with severe combined traumas].

Results of complex treatment of severe combined traumas were compared in 56 patients with using cryosupernatant plasma fraction (CSPF) and fresh frozen plasma--in 112 patients. Better positive dynamics of some laboratory indices was noted as well as lower risk of the development of thromboses, less lethality and better outcomes of the disease when using CSPF. It can be used instead of fresh frozen plasma in complex treatment of patients with severe combined traumas and coexisting DBC-syndrome.

[Use of an endobronchial valve in complex treatment of patients with infiltrative pulmonary tuberculosis].

The results of treatment were analyzed in 118 patients with infiltrative pulmonary tuberculosis. In patients with infiltrative pulmonary tuberculosis, generation of therapeutic hypoventilation and atelectasis of the affected part of the lung by means of an endobronchial valve contributes to stabilization and regression of a tuberculous process, closure of decay cavities, and cessation of bacterial excretion.

[The use of cryosupernatant plasma in complex treatment of pancreonecrosis].

Comparative study of results of complex treatment of pancreonecrosis in 60 patients using cryosupernatant plasma (CSNP) and fresh frozen plasma was carried out. Better positive dynamics in some laboratory indices, less lethality and better outcomes were marked with use of CSNP. It can be used instead of fresh frozen plasma in complex treatment of pancreonecrosis and concomitant DIC syndrome.

[Use of valvular bronchoblocation in the complex treatment of patients with disseminated pulmonary tuberculosis complicated by pulmonary hemorrhage].

The results of treatment are analyzed in 102 patients with disseminated pulmonary tuberculosis complicated by pulmonary hemorrhage. The authors have developed and clinically tested a procedure for arresting pulmonary hemorrhage by creating therapeutic hypoventilation and atelectasis of a lung portion, in which there is a source of bleeding, by using valvular bronchoblocation of the draining bronchus. The application of valvular bronchoblocation to patients with pulmonary bleeding enhances the efficiency of complex treatment and reduces mortality by 4.9 times and a need for emergency and urgent surgical interventions by 7.4 times.

[Correction of phagocyte functional activity in inflammatory focus in patients with deep phlegmons of the neck]. / Korrektsiia funktsional'noi aktivnosti fagotsitov v ochage vospaleniia u bol'nykh s glubokimi flegmonami shei.

High clotting activity (CA) of monocytes, low level of macrophage CA, and increase of proteolytic activity (PA) of neutrophils in the inflammatory focus predominate in patients with deep phlegmons of the neck at the peak of inflammatory process. Blood monocytes retain their anticlotting potential and macrophages possess CA during resolution of the inflammatory process. The neutrophil PA in the blood and lavage fluid was lower during the resolution phase in comparison with the peak of inflammation. Differentiated correction of phagocyte PA and LA in the inflammatory focus, predicted by laboratory findings, reduced the incidence of mediastinitis and improved the disease outcomes.

[Cryoplasma-anti-enzyme combination in the treatment of acute pancreatitis]. / Primenenie krioplazmenno-antifermentrogo kompleksa v lechenii pankreatita.

Results of treatment of 397 patients with acute pancreatitis are analyzed. Use of fresh-frozen and cryosupernatant plasma, heparin and protease inhibitors provide more effective elimination of disseminated intravascular blood coagulation syndrome, disorders of microcirculation that permits to improve results of treatment.

[Treatment in diffuse phlegmons of the neck]. / Lechenie pri razlitykh flegmonakh shei.

The authors made an analysis of results of treatment of 146 patients with diffuse phlegmons of the neck. The use of cryoplasmic-antifermentative complex and plasmapheresis in complex treatment allowed to increase the efficiency of pathogenetic therapy for phlegmons of the neck and contact mediastinitis, to improve the entry of antibiotics and enzyme inhibitors into the inflammation focus and to get better results of treatment.

[Indirect electrochemical oxidation of blood plasma in combined treatment of patients with acute mediastinitis]. / Nepriamoe élektrokhimicheskoe okislenie plazmy krovi v kompleksnom lechenii bol'nykh ostrym mediastinitom.

Treatment results in 61 patients with acute mediastinitis are analyzed. Combined treatment of acute mediastinitis, including cryoplasma-antienzymic complex use and indirect electrochemical blood plasma detoxication, promotes disappearance of microcirculation disorders, to earlier decreasing of endogenic intoxication, outcomes improvement.

[Importance of microcirculatory disorders in combined treatment of acute pleural empyema and pyopneumothorax]. / Znachenie likvidatsii mikrotsirkuliatornykh narushenii v kompleksnom lechenii bol'nykh s ostrymi émpiemami plevry i piopnevmotoraksom.

AIM: To investigate responses to application of quick-frozen or cryosupernatant plasma, heparin and proteinases inhibitors of DIC-syndrome in patients with pleural empyema and pyopneumothorax. MATERIALS AND METHODS: Transfusions of quick-frozen or cryosupernatant plasma, injections of heparin and inhibitors of proteinases were used as an adjuvant to conventional treatment in 548 patients with acute pleural empyema and pyopneumothorax. RESULTS: The addition of cryoplasm-antienzyme complex to conventional treatment of acute pleural empyema resulted in reduced number of lethal outcomes compared to the conventional treatment alone (5.9 vs 14.4%, respectively). CONCLUSION: Transfusion of quick-frozen or cryosupernatant plasma, injection of heparin and inhibitors of proteinases improve microcirculation around the inflammatory focus. In addition to antibiotic therapy and evacuation of the pus from the pleural cavity, the above methods contribute to better outcomes of pleural empyema and pyopneumothorax.

[Kallikrein-kinin system in acute empyema of pleura and pyopneumothorax]. / Kallikrein-kininovaia sistema pri ostroi émpieme plevry i piopmevmotorakse.

In 56 patients with acute empyema of the pleura the level of aggregate kininogen and prekallikrein, free kallikrein and kininase activities in blood plasma and supernatant of pleural exudate were studied. It was established that epsilon-aminocapronic acid, contrykal and gordox suppress free kallikrein activity in the blood plasma and supernatant of pleural exudate. Intravenous and local application of proteolysis inhibitors resulted in improvement of the outcomes of the disease.

[The use of streptokinase preparations in pleural empyema and pyopneumothorax]. / Primenenie preparatov streptokinazy pri émpieme plevry i piopnevmotorakse.

Prevailing fibrin-formation in the pleural cavity entails hypoactivity of trypsin-like proteinases and a high inhibitory potential in the serum and pleural exudate. Streptokinase preparations appeared an effective means of pharmacological pulmonary decortication in patients with high pleural levels of plasminogen. The authors obtained higher efficacy of conservative therapy for pyothorax when they used a specially designed technique of intrapleural administration of streptokinase-activated fresh frozen plasma of the same group. The outcomes of the disease were also improved noticeably.

[The treatment of posttraumatic hemothorax]. / Lechenie posttravmaticheskogo gemotoraksa.

A high procoagulative activity of monocytes, a low procoagulative activity of pulmonary macrophages, and decreased proteolytic activity of leukocytes and monocytes are predominant in patients with coagulated hemothorax. The proteolytic activity of leukocytes of the pleural exudate was higher in these patients than in their blood leukocytes and lower than that of blood leukocytes from healthy donors. Differential correction of phagocytic functional activity in the pleural exudate in terms of the type of hemothorax, its stage, procoagulative and proteolytic activities of phagocytes improve the outcome of the disease.

[The prognosis of the course of pleural empyema and pyopneumothorax]. / Prognozirovanie techeniia émpiem plevry i piopnevmotoraksa.

Proteolytic and procoagulative activities of pleural exudate leukocytes and macrophages along with peripheral blood monocytes can serve an objective criterion in assessing the severity and predicting the course of inflammation in pyothorax (PT) and pyopneumothorax (PPT). A favourable outcome of PT and PPT is reported in high and normal proteolytic activity of leukocytes and in registration of procoagulative macrophage activity, in inhibited proteolytic activity of pleural exudate leukocytes, multidirectional effect on plasma macrophage coagulating activity, in the absence of procoagulative activity in blood monocytes. The prognosis is poor in inhibited proteolytic activity of pleural exudate leukocytes, anticoagulative macrophage activity and monocytic procoagulative activity.