Перспективи застосування апротиніну в щелепно-лицевій хірургії та стоматології (огляд літератури)

Abstract

The article adduces the current experience of using of the aprotinin (inhibitor of proteolisis and kininogenesis) in the clinical medicine. We also highlighted the mechanism of its influence on the organizm and described the indications for it use with therapeutic purposes after surgical pain syndrome. We confirmed the effectivness of drugs based on aprotinin for the treatment in various pathological conditions, because of its anti-inflammatory, antifibrinolitic, antishock action. Nowadays, the drugs which contain the main active substance as aprotinin are used for the prevention and treatment of pancreatitis, pancreonecrosis, hyperfibrinolitic bleeding, complications after thrombolytic therapy and in cardiac surgery. Injection of aprotinin before surgery helps to prevent the development of diffuse bleeding during operation. The anti-inflammatory mechanism of aprotinin has multivalent character. The ability of aprotinin to reduce the production of proinflammatory interleukines and at the same time stimulates the appearance of anti-inflammatory interleukins that allows to use it for reducing of surgery trauma and postoperative pain syndrome. In addition, we presented the results of local application of products containing aprotinin ("Gordoх", "Contrical", "Tachokomb", "Aerus"), used by the physiotherapy. In this article we analyzed recent literature data on the use of aprotinin in clinical dental practice and maxillofacial surgery (treatment of the maxillofacial area soft tissue inflammation, complications of bone fractures, impacted lower third molars surgery). The ability of the aprotinin to reduce the symptoms of inflammation, improve microcirculation, heal postoperative wounds and its positive impact on haemodynamics makes it an alternative to dexamethasone while dealing with the pain and swelling. All above mentioned serves as a base for more widespread application of aprotinin in practical of dentistry and maxillofacial surgery.