IMMUNOLOGICAL REACTIVITY IN PATIENTS WITH UROLOGICAL PROFILE UNDER COMBINED THERAPY

Prevention and treatment of postoperative purulent-inflammatory complications in urological practice remains a subject for study and improvement in all medical centers. The principle of evidence must be taken as a basis of effectiveness of therapy. In this study the quality criteria of demonstrated therapy are immunological parameters.

The purpose of this study is to identify the effectiveness of using monooxidase (NO) containing a gas stream replenishing the deficiency of endogenous NO in a group of patients; and to investigate immunological reactivity in patients under complex therapy included nitrogen monoxide and immunomodulators.

Materials and methods. In this experimental study we determined the functioning of the main links of the patient’s immunological system. They were determined on the basis of the levels of general T-lymphocytes (T-total), T-helper (T-h), T-suppressor (T-s), natural killer (NK), B-lymphocyte and immunoglobulin G, M, A, circulating immune complexes (CIC).

Results. Based on the obtained data, we concluded that the traditional treatment of patients with postoperative complications was less effective than the one proposed in our study. Immunological picture of patient’s condition come back to normal almost from the first day of treatment, and under traditional treatment it was only on the 7th day. Under using complex treatment with nitrogen monoxide, parameters of humoral immunity corresponded to the norm already on the 7–14th day from the beginning of treatment.

Conclusion. NO-containing gas flow application in complex prevention of purulent-inflammatory complications made possible to eliminate wound infection in shorter terms and to shorten the period of patient’s hospitalization. The best results were obtained in terms of immunological reactivity in a clinical trial in patients who received complex therapy included nitrogen monoxide and lymphotropic administration of the immunomodulators.

urology, lymphotropic therapy, immunoglobulin, nitrogen monoxide, postoperative complications, combined therapy

1. Loran O. B., Koridze A. D., Vtorenko Yu. I. Limfotropnaya terapiya v prakticheskoi urologii. Vestnik limfologii. 2007; 1: 17–20. (In Russian).

2. Alyaev YuG, Rapoport LM. Mochekamennaya bolezn’. Aktual’nye voprosy diagnostiki i lecheniya. Vrachebnoe soslovie. 2004; 4: 4–10. (In Russian).

3. Bukhov RV, Danilevskaya OV, Chernyaev AV. Importance of stimulation of choleresis and cholekinesis in the prevention of the formation of bile calculi. Clinical medicine Centrosoyuz. Collection of scientific works of the Department of Hospital Surgery MGMSU, 2006, pp. 17–21. (In Russian).

4. Bukhov RV. Lithotripsy in Multimodality Treatment for Cholelithiasis in Patients at a High Surgical and Anesthesiological Risk. Obshchaya Reanimatologiya (General Reanimatology). 2005; 1 (4): 47–49.

5. Vasilyev AO, Govorov AV, Rewa IA, Schneiderman MG, Pushkarev VA, Pushkar DY. Alternative approaches to prevention and treatment of postoperative complications by introduction of new models urinary catheter. Urology. 2016; 6: 5–10. (In Russian).

6. Vyrenkov YuE. Dinamika limfo-interstitsial’nykh otnoshenii pri narushenii makroi mikrotsirkulyatsii. Mikrolimfologiya [Dynamics of lympho-interstitial relations in the case of disturbance of macroand microcirculation. Microlimology]. Moscow: “Meditsina”, Publ., 1983, pp. 248–271. (In Russian).

7. Vyrenkov YuE. Osnovnye napravleniya razvitiya sovremennoi limfologii. Arkhiv anatomii, gistologii i embriologii. 1989; 96 (6): 14–20. (In Russian).

8. Limfologicheskie metody v khirurgii i intensivnoi terapii [Lymphological methods in surgery and intensive care]. Edited by Vyrenkov YuE, Vtorenko VI, Shevkhuzhev ZA. Moscow, 1997, 29 p. (In Russian).

9. Vyrenkov Yu. E., Shevkhuzhev Z. A., Akhundov I. Limfogennye metody terapii pri vospalitel’nykh zabolevaniyakh organov bryushnoi polosti. Annals of Surgery. 1999; 4: 74–78. (In Russian).

10. Yarema IV, Myl’nikov AV, et al. Endolimfaticheskoe vvedenie antibiotikov kak novyi metod glubokoi antiseptiki. Aseptika i antiseptika [Endolymphatic administration of antibiotics as a new method of deep antiseptics. Aseptic and antiseptic]. Мoscow, 1979, pp. 62–63. (In Russian).

11. Yarema IV, Merzhvinskii IA, Shishlo VK, et al. Metod lekarstvennogo nasyshcheniya limfaticheskoi sistemy. Khirurgiya. 1999; 1: 14–16. (In Russian).

12. Efimenko NA, Chernekhovskaya NE, Vyrenkov YuE. Rukovodstvo po klinicheskoi limfologii [Guide to clinical lymphology]. Мoscow, 2001, 160 с. (In Russian).

13. Moskalenko VI, Gur’ev GS. Kontsentratsiya tsefotaksima v limfouzlakh pri ego limfotropnom vvedenii v usloviyakh NO-terapii. Vestnik limfologii. 2010; 3: 17–22. (In Russian).

14. Moskalenko VI. Limfaticheskaya i NO-terapiya u ranenykh. Vestnik limfologii. 2010; 3: 45–51. (In Russian).

15. Efimenko NA. Rukovodstvo po primeneniyu apparata «Plazon» v khirurgicheskoi praktike [Manual for the use of the device “Plazon” in surgical practice]. Мoscow, 2003, 96 p. (In Russian).

16. Ngo TT, Lenkhoff G. Immunofermentnyi analiz [Immunoenzymatic analysis]. Moscow: “Mir” Publ., 1988, 444 p. (In Russian).

17. Petrov RV. Immunnaya sistema i immunologicheskaya reaktivnost’. Immunologiya [Immune system and immunological reactivity. Immunology]. Мoscow, 1987, p. 16. (In Russian).

18. Karaulov AV. Klinicheskaya immunologiya [Clinical Immunology]. Мoscow, 1999, 604 p. (In Russian).