THE CLINICAL SIGNIFICANCE OF THE COMPREHENSIVE APPROACH STRATEGY FOR THE RATIONAL TREATMENT OF PERITONITIS

Abstract

The article provides information about the surgical results of 525 patients with diffuse peritonitis (DP). The complexity of the DP was evaluated by Mangeym’s peritoneal index (MPI). 337 patients were included in the comparison group (first group), which was treated by the generally accepted methods without immune correction. The main group (188 patients) was divided into two separate subgroups. For 84 patients included in the first subgroup in the background of the complex treatment methods in pre and post-operation period, local and systemic ozone therapy (OT) and the ozone perforator (OP) were used. Metabolic immunomodulator and detoxifier glutoxime (Qt) was added to the second subgroup of patients in addition to local and systemic OT and OP treatment complex. The immune indicators (CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, Ig A, M, G, FI, CEC), the products of lipid peroxidation (DK, MDA, CAT), average molecular weight peptides, residual nitrogen, creatinine, urea, total protein, albumin and electrolytes, ALT, AST, ALP, total Bilirubin examined in the blood of all the patient before and after the operation. TNFα, İL-4 and İL-8 were identified in both groups in progress before surgical treatment and 3-5 days after treatment. Before the operation, in all patients of both groups were appeared violations in the cell and humoral levels of immune and the balance between pro and anti-inflammatory cytokines depended on the complexity of the DP by MPI. The obtained results justify the high clinical effectiveness of the comprehensive approach strategy to the rational treatment of DP.