Изменения свойств эритроцитов крови у родительниц после кесарева сечения в зависимости от метода ведения периоперационного периода

Abstract

Aim: To study the changes in the structural and functional parameters of blood erythrocytes in maternity women during cesarean section, depending on the method of management of the perioperative period (PP), at all its stages. Design: Comparative group retrospective and prospective study. Materials and methods. The study included patients (n = 81) who underwent a planned cesarean section under spinal anesthesia (SA). The control group consisted of 38 maternity hospitals, in which PP was conducted traditionally. In the main group, 43 maternity hospitals were conducted according to the accelerated recovery program: refusal of mechanical intestinal cleansing, glucose-containing drink 2 hours before surgery, antibiotic prophylaxis 1 hour before surgery (cefazolin 2 g intravenously). Blood sampling and examination of the structural and dynamic parameters of the erythrocyte membranes of the patients' blood were carried out at different stages of PP: before CA, after the development of CA, by the end of the operation; umbilical cord blood was also examined. Results. In the control group, the polarity of annular and total lipids, as well as the microviscosity of total lipids, did not significantly change at different stages of Cesarean section. By the end of the operation, the fluidity of annular lipids increased by 24% and the parameter of the efficiency of the transfer of excitation energy from tryptophan residues of erythrocyte membrane proteins by umbilical cord blood to pyrene ((F0–F)/F0) increased by 11%. In the main group, after the development of CA and by the end of the operation, the index (F0–F)/F0 in the membranes of red blood cells decreased by 10%; the fluidity of annular lipids increased to CA and by the end of the operation by 25%, after the development of CA — by 30% relative to the control group to CA. The dissociation constants of 1-anilinonaphthalene-8-sulfonate with plasma proteins and erythrocyte membranes in the control group up to CA differ significantly: Kd2 is 5.34 times greater than Kd1. The number of binding centers in erythrocytes is 12 times less than in plasma proteins. Conclusion. The concept of PUV, which promotes rapid recovery of the patient, can prevent the intensification of oxidative-inflammatory processes, which allows the development of new therapeutic methods to improve the rheological properties of blood in many clinical conditions. Keywords: perioperative period, accelerated recovery program, carbohydrate drink, caesarean section, conformational changes in proteins.