Znamerovskyi S. Pathophysiological mechanisms of development of experimental biliary peritonitis and methods of its correction

Українська версія

Thesis for the degree of Candidate of Sciences (CSc)

State registration number

0419U001703

Applicant for

Specialization

  • 14.03.04 - Патологічна фізіологія

30-10-2019

Specialized Academic Board

Д 64.600.03

Essay

The study was conducted on 180 rats of the Vistar line, the average weight of which was 180-200 g. Animals were divided into 4 groups: 1st group - intact (20 individuals). Group 2 - rats, which were simulated bilious peritonitis without further correction (80 individuals). Group 3 - rats, by which the correction of experimental biliary peritonitis was carried out by means of sanation of the abdominal cavity with a solution of chlorhexidine (0.02%), followed by the use of standard antibiotic therapy. Group 4 - rats, which were modeled biliary peritonitis corrected by using sodium hypochloride, dexamethoxin and sodium hyaluronate. The purpose of the study is to determine the main pathophysiological mechanisms of development of experimental biliary peritonitis and to pathogenetically substantiate the methods of their correction. Summing up the obtained results, we can assert the following. Biliary peritonitis according to severity, prognosis and percentage of lethality depends on endogenous intoxication. The bile peritonitis model used in the experiment is adequate for clinical manifestations, which was confirmed by the dynamics of the studied parameters. By the end of the first day, from the beginning of the experiment, the animals' lives from the group with the simulated bile peritonitis without correction was statistically significantly different from that of rats with complex therapy, which proves the effectiveness of the last one in the early stages of experimental pathology. At the end of the third day, all animals without correction died, groups with antibiotic therapy and integrated correction surviving and had approximately the same rates. By the end of the seventh day, the advantage of proposed complex correction was substantially affected, in comparison with traditional antibiotic therapy, especially in the larger number of surviving animals. Accordingly, a comlex correction was effective both in the early and late stages of the disease. As a result of the conducted studies, it is proved that the leukocyte index of intoxication is an important diagnostic test in the pathogenesis of experimental peritonitis, in particular, on the first and third days of the study, its elevation against the background of the simulated pathological process is noted. The proposed comprehensive sanation method for the abdominal cavity has proved its effectiveness, as evidenced by the normalization of the activity of the enzymes AST and ALT in group 4. When studied aspartate aminotransferase, the most pronounced positive dynamics in the fourth group is observed on the 7th day. The activity of the alanine aminotransferase in the 4th group is more closely related to the values of the norm for the third day. The proposed method of sanation of the abdominal cavity through the complex use of sodium hypochloride, decamethoxin, and sodium hyaluronate confirmed its effectiveness also in the analysis of the dynamics of indices of total protein and bilirubin. In particular, on the 1st and 3rd days of the experiment, the least pronounced decrease in total protein was found in the 4th group of the animals under study, and at 7 days its value in this group even increased slightly compared with the values of intact rats. In analyzing total bilirubin, we also obtained data on the prevalence of positive dynamics in the 4th study group. As much as it appeared in this group on the 3rd day of the experiment. The positive dynamics of the number of red blood cells in proposed by us complex correction method is observed for the third day and is stored up to the 7th. Hemoglobin and hematocrit indices also significantly improve during the study compared with the data of the 2nd and 3rd groups and approach the normative values. In the study of ESR in a group of rats with the proposed treatment method on the 3rd and 7th day, a significant improvement was observed.

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