Efficiency of pharmacotherapy in combined treatment of extended purulent peritonitis

CC BY f
63-67
2
Поделиться
Сабирматов, А., Маматова, Н., & Агзамова, Н. (2023). Efficiency of pharmacotherapy in combined treatment of extended purulent peritonitis . Актуальные проблемы современной фармакотерапии, 1(1), 63–67. извлечено от https://inlibrary.uz/index.php/problems-modern-pharmacotherapy/article/view/21064
Crossref
Сrossref
Scopus
Scopus

Аннотация

Despite the progression and improvement of methods of surgical interventions, the number of peritonitis spread among emergency operations performed is 20-35%, of which 19-60% of cases end in mortality. The main key factor in the etiopathogenesis of peritonitis remains the bacterial link. At the same time, the appearance of highly virulent microflora contributes to the antibiotic resistance of drugs associated with the presence of beta-lactamases [1; 2; 6; 7].


background image

«Актуальные проблемы современной фармакотерапии»

Республиканская научно

-

практическая конференция

63

EFFICIENCY OF PHARMACOTHERAPY IN COMBINED TREATMENT

OF EXTENDED PURULENT PERITONITIS

Sabirmatov A.A.

Tashkent Pediatric Medical Institute

Mamatova N.M.

Tashkent Pediatric Medical Institute

Agzamova N.V.

Tashkent Pediatric Medical Institute

THE RELEVANCE OF THE PROBLEM

Despite the progression and improvement of methods of surgical

interventions, the number of peritonitis spread among emergency operations

performed is 20-35%, of which 19-60% of cases end in mortality. The main key

factor in the etiopathogenesis of peritonitis remains the bacterial link. At the same

time, the appearance of highly virulent microflora contributes to the antibiotic

resistance of drugs associated with the presence of beta-lactamases [1; 2; 6; 7].

It is known that the prognosis of recovery of patients with peritonitis at

58% practically does not depend on treatment with antibacterial drugs. The key

moment in the complex treatment of this disease belongs to the rehabilitation of

the abdominal cavity (SBP). A widely used method of sanitation of the abdominal

cavity (SBP) is currently washing with various medicinal solutions (because

solutions of hydrogen peroxide 3%, furacilin solution, dimexide, sodium

hypochlorite, ozonated solutions, etc.) [2; 4; 5; 9].

According to a number of scientists, the development of the method of

antibacterial photodynamic therapy (AFDT) may be used to solve the above

problems. It has been established that inflamed tissues tend to delay dyes

photosensitizers (FS) and therefore biological materials, such as inflamed tissue, and

pathogenic bacteria, can become objects for exposure to photodynamics [3; 8].

Photodynamic therapy (PDT) requires a photosensitizer, i.e. a drug with a

certain range of radiation absorption, a source of laser or LED radiation

corresponding to the absorption spectrum of the photosensitizer, an endogenous

factor

singlet

oxygen, it is generated during a photochemical reaction.

Photosensitizers are dyes that are sensitive to light of the appropriate wavelength

and are activated (excited) from it.

The purpose of the research is to develop and evaluate the effectiveness of

the antimicrobial PDT method in the complex treatment of diffuse peritonitis (RP)

under experimental conditions.

The material

of the research was laboratory animals 161 white mongrel

rats. The experimental research was performed on 161 animals of mongrel rats,

with weights of 140-180 gr. All animals were in standard vivarium mode.


background image

«Актуальные проблемы современной фармакотерапии»

Республиканская научно

-

практическая конференция

64

The work was carried out in the Central Scientific Research Laboratory (TSNIL)

of the Tashkent Pharmaceutical Institute. Animals were taken out of the

experiment according to the rule of humanism in relation to laboratory animals

by an overdose of anesthesia. At the initial stage, we conducted experimentally in

vitro studies to study the bactericidal properties of methylene blue and LED

radiation in the red color

range with a wavelength of 630 ± 20nm separately, then

in their combination (methylene blue and LED radiation) at different

concentrations and exposure time of LED radiation. At the same time, the

bactericidal properties of 0.02% chlorhexidine solution were studied.

Experimental studies in vivo included 4 series. In the first series, we studied

the effects of methylene blue (MS), LED radiation in the range of 640±20nm, as

well as their combinations (PDT) and 0.02% chlorhexidine solution on the

morphological structure of the parietal and visceral peritoneum in intact animals

(n=75).

In the second series, we developed an experimental model of widespread

peritonitis in 18 rats.

The third series consisted of 28 rats (control group), and abdominal

sanitation (SPBP) in acute experimental peritonitis (OEP) was carried out with
solutions of chlorhexidine in a dilution of 0.02%.

The last series included 40 mongrel rats and lavage was carried out by PDT

using a solution of methylene blue in a concentration of 0.05%.

RESULTS AND DISCUSSION

The purpose of the first stage of research was to study the damaging effect

of chemicals (methylene blue and chlorhexidine), and LED emitters on a healthy

peritoneum. All studies were performed under identical conditions,

simultaneously, under general anesthesia of animals. During and after the

experiment, the condition of the animals was assessed by the established criteria.

The second stage of the study is the development of a model of widespread

peritonitis according to Blinkov Yu.Yu. et al. [A/c: RU 2338265 from 10.11.2008].

By overdosing on anesthesia, the animals were removed from the experiment. To

simulate peritonitis a fecal mixture was made, which was obtained from the colon

of several rats. After the stool was mixed with saline solution, the resulting

mixture was carried out through gauze napkins, and for 20 minutes the mixture

was injected into the abdominal cavity of experimental animals at a dose of 0.5 ml

per 100 g. The animals were in a head-down position at the same time. During

puncture, the tip of the needle was occasionally changed to achieve infection of

the entire abdominal cavity.

The aim of the third stage of the study was to simulate peritonitis,

laparotomy, and sanitation of the abdominal cavity (SBP) with 0.02%

chlorhexidine solution 24 hours after the simulation. Under inhalation ether

anesthesia, mid-laparotomy was performed on experienced animals. Then the

abdominal cavity was inspected, the morphological picture of the peritoneal


background image

«Актуальные проблемы современной фармакотерапии»

Республиканская научно

-

практическая конференция

65

cavity was judged, as well as the state of the parietal and visceral leaf of the

peritoneum; the amount of exudate and composition were measured,

characterization was given, bacteriological seeding of exudate was obtained from

the abdominal cavity, observing the rules of asepsis; a part of the parietal leaflet

of the peritoneum was taken for biopsy. With the help of a syringe, the entire

exudate was sucked out of the abdomen, followed by 3-4 times washing to the

purity of the abdominal cavity with solutions of chlorhexidine in a dilution of

0.02%. The methods listed above did not differ from the main group of animals.

The amount of chlorhexidine for abdominal lavage in the control group was 3 ml,

and the exposure time was 5 minutes.

At the conclusion of the experiment, the wound of the anterior abdominal

wall was sutured through all layers, animals were labeled and sent to a standard

vivarium, where identical conditions were provided. All experimental animals

who underwent surgery with fecal peritonitis, despite the methods of sanitation

of the abdominal cavity for 3 days in the postoperative period (POP), were given

antibiotic therapy with gentamicin at a dosage of 2 mg/kg per div weight,

intramuscularly).

The purpose of the fourth stage of the study was to study the effect of

photodynamic therapy (PDT) in the treatment of diffuse peritonitis RP and

compare the results with the traditional method of abdominal sanitation SBP.

During the operation, the macroscopic picture of the peritoneum in rats

corresponded to the picture of acute diffuse purulent peritonitis

In the main IV series of animals, after determining the status of the

abdominal cavity and the spread of the inflammatory process, the abdominal

cavity was drained and a 0.05% aqueous solution of methylene blue (MS) was

injected in a volume of 2-3 ml, then fluorescence diagnostics were performed to

determine the degree of accumulation of photosensitizer (FS) in the peritoneum.

After that, the abdominal cavity was washed with 0.9% isotonic solutions to pure

waters, fibrin deposits were removed from the abdominal cavity by active

aspiration with a syringe. The abdominal cavity was irradiated for 5 minutes with

an LED device. As a photodynamic therapy (PDT) emitter, the VOSTOK 010203

device was used with an output power of up to 200 MW, a wavelength of

640 ± 20nm., operating in continuous mode.

For photodynamic therapy (PDT), the energy density is equal to 25 to

35 J/cm2 [4].

Experimental animals were derived from an experiment with an overdose

of ether anesthesia. For comparison, we studied: hematology and blood

biochemistry, intoxication indicators, histological materials, and mortality of rats

with acute experimental peritonitis (OEP). In the control group, the abdominal

cavity was washed with a solution of chlorhexidine in a dilution of 0.02%, which

is widely used in surgical practice due to the active bactericidal action of the drug,

many people know that chlorhexidine is sensitive to both gram-positive and

gram-negative pathogenic bacteria.


background image

«Актуальные проблемы современной фармакотерапии»

Республиканская научно

-

практическая конференция

66

Following the events, the antibacterial effect of photodynamic therapy

(PDT) was revealed, after photodynamic therapy (PDT), regenerative functions of

tissues were enhanced, early appearance of granulation in necrotic foci,

acceleration of transplant time for auto dermoplasty of patients with burns [5].

The use of photodynamic therapy (PDT) for purulent wounds has great potential

before traditional methods of treatment, which include treatment with

antiseptics, the use of antibiotics, and antibacterial ointments. And the potential

of photodynamic therapy (PDT) is: for the bactericidal action of PDT, the

spectrum of sensitivity of microorganisms to antibiotics does not matter; with

repeated use of photodynamic therapy (PDT), resistance to the method does not

appear in microorganisms; The method has a direct bacteriostatic and

bactericidal effect, with repeated use it does not affect the microorganism

sideways, due to selective accumulation photosensitizer (FS) in pathogenic cells.

Based on the above, we can say photodynamic therapy (PDT) is actively

developing in medicine, especially in surgery.

RESUME

Despite the development of medicine, especially surgery (diagnostics,

methods of surgery, postoperative measures, development of new technologies),
many questions still remain unresolved and are awaiting their answers. Spilled

purulent peritonitis has been and remains a formidable pathology in abdominal

surgery which still requires research, development of new treatment methods,

and innovative ways of cleansing from pathogenic cells of the abdominal cavity,

which help to improve the results of treatment of spilled purulent peritonitis.

REFERENCES:

1.

Kirkpatrick A.W. Closed or Open after Source Control Laparotomy for

Severe Complicated Intra-Abdominal Sepsis (the COOL trial): study protocol for a
randomized controlled trial [Text] / A.W. Kirkpatrick, F. Coccolini, L. Ansaloni et

al. World J Emerg Surg.

2018.

Vol.13.

P. 26.

2.

Суздальцев И.В. Особенности морфологического изменения

брюшины при различных видах санации брюшной полости [Текст] / И.В.

Суздальцев, А.Г. Бондаренко, В.Н. Демьянова и др. // Материалы XII Съезда

хирургов России. –

Ростов

-

на

-

Дону, 2015. –

С. 854 –

854.

3.

Hamblin M.R., Dai T. Can surgi

с

al site infe

с

tion be treated by

photodynami

с

ther

а

py. Photodiagnosis Photodyn. Ther.-2010.-Vol.7 (2).-p.134-

136.

Абсцессы брюшной полости как причина послеоперационного

перитонита

Барсуков К.Н., Рычагов Г.П. Хирургия. Восточная Европа

. 2012.

№ 3 (3). С. 22

-24.

4.

Актуальные проблемы перитонита в современных условиях / С.Н.

Стяжкина, А.А. Акимов, Е.С. Овчинникова [и др.]// Журнал научных статей

Здоровье и образование в XXI веке. –

2019.

–Т.21,№4.–

С. 74–

77.


background image

«Актуальные проблемы современной фармакотерапии»

Республиканская научно

-

практическая конференция

67

5.

Баймагамбетова А., Муканова У.А, Рысбеков М.М. Разработка

методики лечения у больных с разлитыми гнойными перитонитами и

абсцессами брюшной полости. Вестник Казахского национального

медицинского университета. 2020. № 2. С. 326

-329.

6.

Воронков Д.Е, Костырной А.В., Суляева. О.А. Санации брюшной

полости при лечении распространенного перитонита. 2011, том 14, №4 ч.1

(56) Таврический медико

-

биологический вестник. Стр. 42

-43.

7.

Григорьев Е.Г. Санация брюшной полости при перитоните / Е.Г.

Григорьев, Н.И. Аюшинова // Материалы IX Всероссийской конференции

общих хирургов с международным участием «Перитонит от А до Я». –

Ярославль, 2016. –

С. 206 –

207.

8.

Лечение экспериментального перитонита у крыс Морозов А.М.,

Сергеев А.Н., Кадыков В.А., Пельтихина О.В. В сборнике: сборник статей

Международного научно

-

исследовательского конкурса. 2019. С. 78

-84.

9.

Азизова, Р., Шерова, З., & Валиева, Т. (2023). Изучение

антипиретической и анальгетической эффективности и переносимости

нестероидных противовоспалительных средств. Актуальные проблемы

педиатрической фармакологии, 1(1), 29

-31.

10.

Карабекова, Б., Мухитдинова, М., & Азизова, Р. (2023). Проблемы

рационального

использования

лекарственных

средств.

Журнал

биомедицины и практики, 7(3/1), 134

-139. https://doi.org/10.26739/2181 -

9300-2021-3-20

11.

Касымова, Ш. Ш., & Хакбердиева, Г. Э. (2021). Применение

Десмопрессина при лечении ночного энуреза у детей. In НАУКА РОССИИ:

ЦЕЛИ И ЗАДАЧИ (pp. 35

-36).

12.

Мавлянова, Н. Т., Шерова, З. Н., Шоабидова, К. Ш., & Норматова, К. Ю.

(20

21). ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ ПРОБИОТИКОВ В КОМПЛЕКСНОМ

ЛЕЧЕНИИ ОСТРЫХ КИШЕЧНЫХ ИНФЕКЦИЙ У ДЕТЕЙ. Электронный

периодический рецензируемый научный журнал «SCI

-

ARTICLE. RU», 15.

13.

Азизова, Р., & Шерова, З. (2023). Рациональная реабилитационная

терапия больных,

перенесших COVID

-

19 с бронхолегочными заболеваниями.

Актуальные проблемы педиатрической фармакологии, 1(1), 77

-78.

14.

Касымова, Ш. Ш., Г. Э. Хакбердиева, and Ш. А. Абдуразакова.

"Эффективность применения интерактивных методов обучения в

медицинских вузах." Стратегии и тренды развития науки в современных

условиях 1 (2020): 12

-16.

15.

МАВЛЯНОВА, Н. Т., & АГЗАМОВА, Н. В. (2023).

ANALYSIS OF

ANTIBACTERIAL DRUGS IN THE TREATMENT OF RESPIRATORY DISEASES IN

CHILDREN.

ЖУРНАЛ БИОМЕДИЦИНЫ И ПРАКТИКИ, 8(2).

16.

Менликулов, П. Р., Маматова, Н. М., Файзиева, Н. Н., Горбунова, И. Г., &

Турсунов, Д. Ш. (2010). Характеристика отношения студенческой молодежи к

табакокурению. Наркология, 9(12), 57

-61.

Библиографические ссылки

Kirkpatrick A.W. Closed or Open after Source Control Laparotomy for Severe Complicated Intra-Abdominal Sepsis (the COOL trial): study protocol for a randomized controlled trial [Text] / A.W. Kirkpatrick, F. Coccolini, L. Ansaloni et al. World J Emerg Surg. – 2018. – Vol.13. – P. 26.

Суздальцев И.В. Особенности морфологического изменения брюшины при различных видах санации брюшной полости [Текст] / И.В. Суздальцев, А.Г. Бондаренко, В.Н. Демьянова и др. // Материалы XII Съезда хирургов России. – Ростов-на-Дону, 2015. – С. 854 – 854.

Hamblin M.R., Dai T. Can surgiсal site infeсtion be treated by photodynamiс therаpy. Photodiagnosis Photodyn. Ther.-2010.Vol.7 (2).-p.134-136.Абсцессы брюшной полости как причина послеоперационного перитонита Барсуков К.Н., Рычагов Г.П. Хирургия. Восточная Европа. 2012. № 3 (3). С. 22-24.

Актуальные проблемы перитонита в современных условиях / С.Н. Стяжкина, А.А. Акимов, Е.С. Овчинникова [и др.]// Журнал научных статей Здоровье и образование в XXI веке. –2019.–Т.21,№4.– С. 74–77.

Баймагамбетова А., Муканова У.А, Рысбеков М.М. Разработка методики лечения у больных с разлитыми гнойными перитонитами и абсцессами брюшной полости. Вестник Казахского национального медицинского университета. 2020. № 2. С. 326-329.

Воронков Д.Е, Костырной А.В., Суляева. О.А. Санации брюшной полости при лечении распространенного перитонита. 2011, том 14, №4 ч.1 (56) Таврический медико-биологический вестник. Стр. 42-43.

Григорьев Е.Г. Санация брюшной полости при перитоните / Е.Г. Григорьев, Н.И. Аюшинова // Материалы IX Всероссийской конференции общих хирургов с международным участием «Перитонит от А до Я». – Ярославль, 2016. – С. 206 – 207.

Лечение экспериментального перитонита у крыс Морозов А.М., Сергеев А.Н., Кадыков В.А., Пельтихина О.В. В сборнике: сборник статей Международного научно-исследовательского конкурса. 2019. С. 78-84.

Азизова, Р., Шерова, З., & Валиева, Т. (2023). Изучение антипиретической и анальгетической эффективности и переносимости нестероидных противовоспалительных средств. Актуальные проблемы педиатрической фармакологии, 1(1), 29-31.

Карабекова, Б., Мухитдинова, М., & Азизова, Р. (2023). Проблемы рационального использования лекарственных средств. Журнал биомедицины и практики, 7(3/1), 134-139. https://doi.org/10.26739/2181 -9300-2021-3-20

Касымова, Ш. Ш., & Хакбердиева, Г. Э. (2021). Применение Десмопрессина при лечении ночного энуреза у детей. In НАУКА РОССИИ: ЦЕЛИ И ЗАДАЧИ (pp. 35-36).

Мавлянова, Н. Т., Шерова, З. Н., Шоабидова, К. Ш., & Норматова, К. Ю. (2021). ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ ПРОБИОТИКОВ В КОМПЛЕКСНОМ ЛЕЧЕНИИ ОСТРЫХ КИШЕЧНЫХ ИНФЕКЦИЙ У ДЕТЕЙ. Электронный периодический рецензируемый научный журнал «SCI-ARTICLE. RU», 15.

Азизова, Р., & Шерова, З. (2023). Рациональная реабилитационная терапия больных, перенесших COVID-19 бронхолегочными заболеваниями. Актуальные проблемы педиатрической фармакологии, 1(1), 77-78.

Касымова, Ш. Ш., Г. Э. Хакбердиева, and Ш. А. Абдуразакова. "Эффективность применения интерактивных методов обучения в медицинских вузах." Стратегии и тренды развития науки в современных условиях 1 (2020): 12-16.

МАВЛЯНОВА, Н. Т., & АГЗАМОВА, Н. В. (2023). ANALYSIS OF ANTIBACTERIAL DRUGS IN THE TREATMENT OF RESPIRATORY DISEASES IN CHILDREN. ЖУРНАЛ БИОМЕДИЦИНЫ И ПРАКТИКИ, 8(2).

Менликулов, П. Р., Маматова, Н. М., Файзиева, Н. Н., Горбунова, И. Г., & Турсунов, Д. Ш. (2010). Характеристика отношения студенческой молодежи к табакокурению. Наркология, 9(12), 57-61.

inLibrary — это научная электронная библиотека inConference - научно-практические конференции inScience - Журнал Общество и инновации UACD - Антикоррупционный дайджест Узбекистана UZDA - Ассоциации стоматологов Узбекистана АСТ - Архитектура, строительство, транспорт Open Journal System - Престиж вашего журнала в международных базах данных inDesigner - Разработка сайта - создание сайтов под ключ в веб студии Iqtisodiy taraqqiyot va tahlil - ilmiy elektron jurnali yuridik va jismoniy shaxslarning in-Academy - Innovative Academy RSC MENC LEGIS - Адвокатское бюро SPORT-SCIENCE - Актуальные проблемы спортивной науки GLOTEC - Внедрение цифровых технологий в организации MuviPoisk - Смотрите фильмы онлайн, большая коллекция, новинки кинопроката Megatorg - Доска объявлений Megatorg.net: сайт бесплатных частных объявлений Skinormil - Космецевтика активного действия Pils - Мультибрендовый онлайн шоп METAMED - Фармацевтическая компания с полным спектром услуг Dexaflu - от симптомов гриппа и простуды SMARTY - Увеличение продаж вашей компании ELECARS - Электромобили в Ташкенте, Узбекистане CHINA MOTORS - Купи автомобиль своей мечты! PROKAT24 - Прокат и аренда строительных инструментов