Infusion therapy during benign mechanical jaundice
Abstract
Aim. To improve the effectiveness of perioperative use of the nitric oxide donator - Tivortin in patients with mechanical benign jaundice.
Material and methods. The prospective randomized study of the perioperative period course of 80 patients with mechanical jaundice was conducted. In the 1st -the main group of 42 patients (52.5%), Tivortin was included in the infusion therapy at a dose of 200 ml/day for 5 days before surgery and 8 days in the postoperative period. The 2nd – control group included 38 (47.5%) patients who underwent perioperative infusion therapy without the use of Tivortin.
Results and discussion. Preoperative use of Tivortin provided a reduction in levels of Medium Mass Molecules (MMM) (from 3.7±0.06 standard units to 2.46±0.05 standard units), the Malonic Dipeptide (MDP) level (from 5.2±0.09 nmol/L to 4.4±0.02 nmol/L). Patients of the main group showed an increased level of nitric oxide (from 16.4±3.2 μmol/L to 27.2±1.4 μmol/L) on the background of decreasing concentration of endotoxin (ET) (from 415.3±6.3 units/ ml to 0.5±0.2 units/ml) and endothelin 1 (from 2.1±1.2 μmol/l to 0.6±0.18 μmol/l), and Desquamated endothelial cells circulating in the blood (from 13.3±1.4 cell/100 to 4.9±0.4 cell/100).
Conclusion. The inclusion of a nitric oxide donator - Tivortin in the complex of peri and post-decompression drug therapy for patients with mechanical benign jaundice reduces the frequency of post-decompression liver failure.
About the Authors
Z. A. Azizzoda
SEI «Avicenna Tajik State Medical University»
Tajikistan
Tajikistan
Azizzoda Zubaidullo Abdullo - Candidate of medical sciences, Doctoral student of the Surgical Diseases Department №1
Tel: +(992)987217177
K. R. Ruziboyzoda
SEI «Avicenna Tajik State Medical University»
Tajikistan
Tajikistan
The Department of Surgical Diseases No. 1
I. K. Kurbonov
SI «Istiklol Health Complex»
Tajikistan
Tajikistan
References
1. Galperin E.I. Mekhanicheskaya zheltukha: sostoyanie “mnimoy stabilnosti”, posledstviya “vtorogo udara”, printsipy lecheniya [Mechanical jaundice: state of « false stability «, consequences of the «second stroke», principles of treatment]. Annaly khir. Gepatol - Annals of Surgery, 2011, Vol. 16, No. 3, pp. 16–25.
2. Kyzhyrov Zh. N. Algoritm diagnostiki i khirurgicheskoy taktiki pri mekhanicheskoy zheltukhe [Algorithm of diagnostics and surgical tactics in mechanical jaundice]. Vestnik KazNMU - Bulletin of the Kazakh National Medical University, 2014, No. 2 (2), pp. 257-264.
3. Lomakin I. A. Diagnostika i lechebnaya taktika u bolnykh s mekhanicheskoy zheltukhoy [Diagnostics and treatment tactics in patients with mechanical jaundice]. Klinicheskaya praktika - Clinical practice, No. 3, 2012.
4. Pakhomova R. A. Klinicheskie proyavleniya mekhanicheskoy zheltukhi i pechenochnoy nedostatochnosti v zavisimosti ot stepeni tyazhesti mekhanicheskoy zheltukhi dobrokachestvennogo geneza [Clinical manifestations of mechanical jaundice and liver failure depending on the severity of benign mechanical jaundice]. Sovremennye problemy nauki i obrazovaniya - Modern problems of science and education, 2017, No. 6, pp. 48-55.
5. Podoluzhnyy V. I. Mekhanicheskaya zheltukha: printsipy diagnostiki i sovremennogo khirurgicheskogo lecheniya [Mechanical jaundice: principles of diagnosis and modern surgical treatment]. Fundamentalnaya i klinicheskaya meditsina - Fundamental and clinical medicine, 2018, Vol. 3, No. 2, pp. 82-92.
6. Styazhkina S. N. Mekhanicheskaya zheltukha osnovnoe oslozhnenie gepatopankreatobiliarnoy sistemy [Mechanical jaundice is a major complication of the hepatopancreatobiliary system]. Vestnik nauki i obrazovaniya - Bulletin of Science and Education, 2017, Vol. 1, No. 5 (29), pp. 103-105.
7. Styazhkina S. N. Aktualnye problemy mekhanicheskoy zheltukhi v khirurgii [Current Problems of Mechanical Jaundice in Surgery]. Mezhdunarodnyy zhurnal prikladnykh i fundamentalnykh issledovaniy - International Journal of Applied and Fundamental Research, 2016, No. 7-3, pp. 427- 430.
8. Shevchenko Yu. L. Khirurgicheskaya taktika pri sindrome mekhanicheskoy zheltukhi [Surgical tacticsfor mechanical jaundice syndrome]. Vestnik nats. med. khir. tsentra im. N.I. Pirogova - Bulletin of the National Medical and Surgical Center named after N. I. Pirogov, 2009, Vol. 4, No. 1, pp. 10–13.
9. Archer S. B. et al. Bile Duct Injury During Laparoscopic Cholecystectomy // Results of a National Survey. Annals of Surgery, 2001, Vol. 234, No. 4, pp. 549 – 558.
10. Berber E., Engle K.L., String A. Selective use of tube cholecystostomy with interval laparoscopic cholecystectomy in acute cholecystitis. The Archives of Surgery, 2013, Vol. 135, pp. 341-346.
Review
For citations:
Azizzoda Z.A., Ruziboyzoda K.R., Kurbonov I.K. Infusion therapy during benign mechanical jaundice. Health care of Tajikistan. 2020;(4):5-10. (In Russ.)
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