RESUMEN
Acute purulent mediastinitis (APM) is one of the most difficult forms of surgical infection with severe clinical course and lethality from 17 to 80%. Overall 80 patients with APM were treated; plasmapheresis in postoperative period was used at 66 of them. The main criteria of negative prognosis at the patients with APM were elderly age, high score on APACHE-2, SAPS-2 and SOFA scales, higher level of creatinine and urea serum concentration, hyperglycemia, leucopenia. Early application of plasmapheresis was associated with lower lethality (12.5% at the group with early beginning of plasmapheresis, 35.3% at the group with late beginning, 36.2% at the control group). Plasmapheresis promotes normalization of hemostasis, microcirculation and immune parameters, reduction of intoxication and systemic inflammation syndrome.
Asunto(s)
Infecciones Bacterianas/complicaciones , Mediastinitis/microbiología , Mediastinitis/terapia , Plasmaféresis/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Mediastinitis/mortalidad , Persona de Mediana Edad , Cuidados Preoperatorios , Tasa de SupervivenciaRESUMEN
Therapeutic effect of lyophilized xenogenic hepatocytes was demonstrated on 30 dogs with acute hepatic failure and on white mice. The major biochemical values were corrected and the yeast fermentation test showed biological activity of isolated hepatocytes. Clinically, lyophilized hepatocytes were used in the treatment of patients with acute hepatic failure: orally in 47 and for extracorporeal dialysis in 8. The therapeutic effect of lyophilized hepatocytes is based on active detoxication and hemostasis correction. Clinical, laboratory, and instrumental studies showed improvement of the clinical status, decreased encephalopathy, and accelerated repair processes in the liver. Addition of lyophilized hepatocytes to combined therapy decreased the mortality by 2.5 times.
Asunto(s)
Trasplante de Células , Fallo Hepático/terapia , Hígado/citología , Administración Oral , Animales , Perros , Liofilización , Humanos , Hígado/metabolismo , Regeneración Hepática , Ratones , Diálisis Renal , Porcinos , Factores de Tiempo , Trasplante HeterólogoRESUMEN
The paper describes different methods for using isolated hepatocytes to compensate hepatic dysfunctions and to treat hepatic failure. Most of them are safe and produce no complications if isolated hepatocytes are separated from blood with the semipermeable membrane. The survival and functional activity of isolated hepatocytes transplanted into different places and organs are ambiguous and unequal in terms of efficiency. Search for a rational and optimal method for implantation of isolated hepatocytes, for conditions for their functioning, for combinations of different cells, for proliferation of the implanted cells is a subject of special interest and it is in progress. Many procedures have been experimentally justified and are being now used clinically to treat hepatic failure in various hepatic diseases.