THE USE OF HYALURONIC ACID FOR THE TREATMENT OF ADHESIVE INTESTINAL OBSTRUCTION IN CHILDREN

Abstract

The purpose of the explore the possibility of using hyaluronic acid for the treatment of intraperitoneally adhesions in experiment and at children. We used hyaluronic acid – “Defensal”. To achieve the goal, we have done the series of experimental studies on 60 infantile rats, weighing 100±20 mg. Animals were divided into two groups: group – modeling of intra-abdominal adhesions (25 rats); group II – treatment of adhesions. In II group of rats carried out the separation of adhesions on the 30th day of the experiment. For the treatment of adhesions was performed by flooding the abdominal cavity of the solution “Defensal” with the amount of 8 ml (25 rats). 10 rats were control group. The decapitation of the rats were on the 30th day. The parts of terminal ileum (TI) were taken to study morphological changes of the wall ileum and APUD-system (system neuro-endocrine regulation of the gastrointestinal tract). There were two reactions to identify secretory granules into the apudocyte. The argyrophil Grimelius and the argentophil MassonHamperlmethods were carried out. 84 children were operated on AIO. The children were divided into two groups. I group were “Defensal” were not to use (56 patients). II group were “Defensal” to use (28 patients). The follow-up of children from 1 to 4 years. In the group of rats using “Defensal”, there has been an absence of adhesions in 42.86% of cases. The adhesions isolated spikes, that will not deform the intestine were identified in 42.86%.The multiple adhesions that not to deform intestine were in 14.28%. The study of tissue fibrinolytic activity of TI (was not involved and involved into adhesions) were showed the tendency to its increase when using the solution of “Defensal” but not reaching the data control. In the simulation of adhesions (I group) reported a decrease in the number apudocytes and decrease in their functional activity as evidenced by the size of argyrophilic granules. In the II group were coloring of the test material by Grimelius in the glands of the mucous membrane a sufficient number apudocytes was found. In the I group (56 children) in the first year after surgery with adhesion syndrome turned 13 (23.21%) children, up to 4 years – 20 (35.71%) patients. In the II group (28 children) adhesion syndrome (cured conservatively) over 2.5 years postoperative period turned 2 (7.14%) patients, indicating the effectiveness of “Defensal” for the purpose for treatment of the adhesions abdominal cavity at children.