ТЕРАПЕВТИЧЕСКОЕ ПРИМЕНЕНИЕ ПЛАЗМАФЕРЕЗА В ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ОСТРОГО ДОБРОКАЧЕСТВЕННОГО ХОЛАНГИТА
Ключевые слова:
Острый доброкачественный холангит, плазмаферез, эндотоксемия, печеночная дисфункция, терапевтическая детоксикация, хирургическое лечениеАннотация
Данное исследование оценивает терапевтическую эффективность плазмафереза (ПФ), интегрированного в протокол хирургического лечения острого доброкачественного холангита. Исследование охватило 17 пациентов, которым был применен новый терапевтический подход, сочетающий плазмаферез с непрямой электрохимической детоксикацией, использующей раствор гипохлорита натрия и озонирование для восстановления аутоплазмы.
Применение плазмафереза наряду с комплексным фармакологическим вмешательством продемонстрировало значительную клиническую эффективность у пациентов с холангитом, осложненным печеночной недостаточностью. Заметные улучшения параметров эндотоксемии и функции печени наблюдались в течение 48-72 часов после вмешательства. В частности, уровни аспартатаминотрансферазы (АсАТ) снизились с 1,4±0,05 до 0,5±0,02 ммоль/л, в то время как аланинаминотрансфераза (АлАТ) снизилась с 1,1±0,06 до 0,37±0,01 ммоль/л.
Включение плазмафереза с антигипоксантной и антиоксидантной терапией привело к существенному снижению маркеров окислительного стресса и параметров эндотоксемии. К 4-му дню диеновые конъюгаты (ДК) снизились до 1,3±0,03 опт.пг/мл, уровни малонового диальдегида (МДА) снизились до 3,2±0,21 ммоль/мг, а концентрация лактата в крови уменьшилась до 2,4±0,6 ммоль, что указывает на значительное улучшение метаболического статуса пациентов.
Эти результаты позволяют предположить, что плазмаферез, интегрированный в комплексный протокол лечения, представляет собой эффективный терапевтический метод лечения острого доброкачественного холангита, особенно в случаях, осложненных печеночной дисфункцией и эндотоксемией.
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