Abstract
Purpose: to study changes in nonspecific resistance and cytokine regulation in patients with postoperative peritonitis with abdominal sepsisMaterials and methods. The clinic treated 456 patients with postoperative peritonitis who were treated in the surgery department of the municipal non-profit enterprise Regional Clinical Hospital of Ivano-Frankivsk Regional Council in the period from 2000 to 2021. Immunological studies were performed in 66 patients with varying severity of abdominal sepsis and its complications.Research results and their discussion. In patients with postoperative peritonitis with abdominal sepsis, the phagocytic index during the first week of hospital stay was in control. However, on the 10th-11th day, the phagocytic index decreased 1.6 times, which progressed until the end of the third week of treatment - on the 14th-21st day, the phagocytic index was 2.7 times smaller than the control. The phagocytic count in patients with PP with abdominal sepsis reached maximum values in the first day of the disease (3 ± 0.26). Later in the treatment process, this figure gradually decreased and on day 14-21 came to normal and amounted to 1.96 ± 0.10. The index of completeness of phagocytosis on the first day of the disease was1,59 ± 0,20. By 2-3 days it decreased by 1.44 ± 0.20 and returned to normal by 14-21 days. Circulating immune complexes were normalized by 5-7 days of the disease.
Highlights
Materials and methodsIn patients with postoperative peritonitis complicated by abdominal sepsis in a severe condition, the phagocytic index decreased compared with the control by 1.3 times on the first day and was 49.33 ± 4.20% with a subsequent increase to 56.17 ± 3.67 for 14-21 days
Purpose: to study changes in nonspecific resistance and cytokine regulation in patients with postoperative peritonitis with abdominal sepsis Materials and methods
The clinic treated 456 patients with postoperative peritonitis who were treated in the surgery department of the municipal non-profit enterprise Regional Clinical Hospital of Ivano-Frankivsk Regional Council in the period from 2000 to 2021
Summary
In patients with postoperative peritonitis complicated by abdominal sepsis in a severe condition, the phagocytic index decreased compared with the control by 1.3 times on the first day and was 49.33 ± 4.20% with a subsequent increase to 56.17 ± 3.67 for 14-21 days. The phagocytic count in patients with postoperative peritonitis with abdominal sepsis on the first day of the disease was 1.7 times lower than the control level and reached maximum values at 5-7 days and was 3.11 ± 0.19. The peculiarity of changes in nonspecific resistance in patients with abdominal sepsis, which were in an extremely severe condition, is that intensive detoxification therapy can only temporarily normalize certain parts of phagocytosis, which is not enough to prevent the development of endogenous intoxication – the concentration of CIC in the blood progressively increases throughout the treatment period. Loss of functionality and reactivity of immune cells in the early stages of peritonitis leads to general immunosuppression in the form of a significant decrease in their absolute number, which is a sign of the development of structural, primarily cellular, defects in the immune system
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