INTRAVENOUS LASER BLOOD IRADIATION IN THE COMPLEX TREATMENT OF PERITONITIS

R.D. MUSTAFAYEV, R.I. KIZEVADZE

State Research and Clinical Center for Laser Medicine, Moscow, RUSSIA

Purpose: To assess effectiveness of intravenous laser blood irradiation (ILBI) in the complex treatment of patients with acute peritonitis accompanied with the syndrome of endogenous intoxication.

Materials and methods: 164 patients (94 male and 72 female aged 16- 85) with acute peritonitis having endogenous intoxication have been taken into the study. All patients were divided into three groups using the classification scale of endotoxicosis at peritonitis developed by Gostischev VK and Shulkalin BK. There were 50 patients with endotoxicosis of degree I; 48 patients with endotoxicosis of degree II ( medium degree); 66 patients with endotoxicosis of degree III. 90 patients were treated conventionally plus ILBI with laser device «Matrix VLOK 405». Irradiation power at the end of the lightguide tip was 0.5-1.0 mWt, exposure time was 10 min for one session. Laser therapy course consisted of 8-10 sessions. The effectiveness of combined conservative treatment was evaluated with laboratory and clinical findings: dynamics of peroxide lipid oxidation (PLO) and antioxidant blood activity, levels of medium molecules as well as leucocytic intoxication levels.

Results: Purulent infection in the abdominal cavity causes activation of PLO process and depression of antioxidant defense system in the organism. It leads to the excessive accumulation of highly toxic intermediate and finished products of PLO reaction which is one of the chains in pathogenesis of endogenous intoxication. ILBI technique used in the complex treatment of acute peritonitis accompanied with a syndrome of endogenic intoxication (degrees I-II) produces a positive effect practically at all stages of postoperative period. Malonic dialdehyde, diene conjugates as well as medium molecules and leucocytic intoxication indexes are rapidly decreasing what leads to their normalization . Catalase and peroxidase activity is increasing. ILBI activates antioxidant defense system, provides utilization of PLO products in metabolic processes, restores homeostasis and functions of essential organs.

Conclusion: Complex treatment of patients with acute peritonitis accompanied with a syndrome of endogenic intoxication is potentiated with addition of ILBI (405 nm) technique because it has a detoxication effect due to a direct impact at medium molecular toxins of protein nature as the results of which less toxic compounds are formed, erythrocyte hemolytic resistance increases, hepatic and renal functions improve.

Date: 2014-12-28; view: 978