SU1503831A1 - Method of treatment of portal-systemic encephalopathy - Google Patents

Abstract

The invention relates to medicine, namely to infectious diseases and hepatology, and can be used in the treatment of patients with hepatic encephalopathy, which develops in acute, chronic and toxic hepatitis, liver cirrhosis. The aim of the invention is to reduce the duration of treatment and reduce mortality. The goal is achieved by supplementing the patient with irradiated autologous blood in the amount of 1-2 ml / kg 2-6 times per course of treatment with an interval of 1-5 days. The invention makes it possible to shorten the hospital stay and reduce mortality.

Description

The invention relates to medicine, infectious diseases and hepatology, and can be used in the treatment of patients with hepatic encephalopathy, which develops in acute, chronic and toxic hepatitis, cirrhosis of the liver.

The purpose of the invention is to reduce the time of treatment, reduce mortality due to the additional administration of autologous autologous blood to the patient.

The method is as follows.

The autologous blood was irradiated with a MD-73M ultraviolet irradiator in an amount of 1-2 ml / kg. Assign from 2 to 6 procedures with an interval of 1-5 days. The irradiation is carried out in a quartz cuvette of size 140X33X1.0 mm, mounted on the top panel of the apparatus above the arc quartz lamp DRB-8, emitting mainly at a wavelength of 254 nm. Blood sampling is done with a dotted peripheral vein. According to the system collected from

Hose system for blood transfusion PK-1101 with an inner diameter of 4 mm and including a quartz cuvette, blood is supplied with a roller pump mounted on an RD-09 electric motor into a sterile vial containing 50.0 ml of saline and 5000 IU of heparin. The hose system is pre-filled with the solution from the vial. In the presence of hemorrhagic syndrome or significant changes in the coagulogram of the patient, in order to avoid the development of bleeding after the administration of heparin, for use to collect blood, use vials of Glugiroir. After taking the estimated amount of blood, the vial with blood is inverted. The toggle switch on the vertical panel of the device is placed in the “patient” position and the patient is returned to the blood, re-irradiating it in a cuvette. The rate of blood collection and return is 18-22 ml / min. The procedure lasts 15-30 minutes.

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The method is illustrated by the following examples.

Example I. Ill B., 22 years old, was admitted to the intensive care unit and intensive care with complaints of nausea, vomiting, dizziness, loss of appetite, severe weakness, feeling of failure. An objective examination of the patient is inhibited, drowsy, answers questions in monosyllables. Liver at the costal arch, jaundice of p. Diagnosis: obdiy viral hepatitis B.HbsAg, (-} -). It is desirable. Acute hepatic failure. Prekoma I. The patient underwent 2 sessions of AUFOK every other day, a wavelength of 254 nm, the amount of irradiated blood 1 ml / kg. As a result, the mood improved, the symptoms of encephalopathy disappeared, the size of the liver increased. Dynamics of laboratory parameters

To AUFOK After AlAT57.5mmol / l24

Bilirubin 152 micromol / l 82 Prothrombin

Erythrocytes 4,9X10124,3x10

Leukocytes 8,0x1088,0x10

ESR11 mm / h9

Example 2. Ill B., 24 years old, was admitted with complaints of nausea, vomiting, dizziness, loss of appetite, weakness, jaundice. On the 3rd day of the inpatient stay, there were disturbances in the sleep rhythm, the sensation of dips, cutting inhibition, fever, psychomotor agitation. An objective examination of consciousness at the level of pores, the size of the liver decreased. Diagnosis: poisoning by an unknown house. Toxic hepatitis. Acute hepatic failure. Prekoma II. There was an activation of auto- and exoflora: S / were isolated from blood. aureus euterobacier klebstela. The complex of medical events included AUFOK. Conducted 4 sessions, a wavelength of 254 nm, the amount of irradiated blood 2 ml / kg. As a result, the patient's state of health improved, the temperature returned to normal, the consciousness became clear, psychomotor agitation, sleep disturbance disappeared, appetite decreased, jaundice decreased, liver size increased, and sterile blood culture increased.

Dynamics of laboratory parameters.

Before AUFOK after

AlAT58m mol / l0.69

Bilirubin 142.8-μmol / l 23.0 Prothrombin 50% 81%

Red blood cells 5, IX 10 23.9X10 2

Leukocytes 11, 4X10

ESR8 mm / h28

Example 3. Ill B., 37 years old. Received complaints of severe weakness, fatigue, irritability, loss of appetite, drowsiness, dizziness, jaundice, swelling in the legs, an increase in the size of the abdomen. Diagnosis: chronic virus0

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ny hepatitis, cirrhotic stage. Aggravation. Hepatic renal failure II-III Art. Portal hypertension. Ascites Hemorrhagic syndrome. Previously, the doctor did not go. She received traditional therapy for a month without effect, including hormonal agents. The state remained heavy, kept at a low-grade fever. After 6 sessions of AUFOK (radiation at a wavelength of 254 nm), after 5 days in an amount of 2 ml / kg, the patient's well-being improved significantly, sleep, appetite, temperature normalized, weakness, dizziness disappeared, jaundice and ascites decreased, the patient became more active and more cheerful. The positive dynamics of laboratory parameters was observed: after the first two sessions, bilirubin decreased from 48 to 19 µmol / L. After the course of treatment with AUFOK, correction of dysproteinemia was observed, as evidenced by an increase in sublimate titer from 1.2 to 1.4. Hemoglobin increased from 81 to 102 g / l, erythrocytes from 2.9X10 to 3.2X10 -, prothrombin from 62.1 to 70.2%, the number of leukocytes decreased from 8, 7.2X10®.

Example 4. Patient T., 32 years old, was admitted to the intensive care unit and intensive care on the 11th day of illness (8th day of jaundice) with complaints of dizziness, severe weakness, loss of appetite, feeling of dips, drowsiness. On examination, he is slowed down, drowsy, periodically starts talking, is aggressive. Diagnosis: chronic viral hepatitis B.Hb.s-Ag (+). Acute hepatic failure. Prekoma I-II. The complex of therapeutic measures included 2 sessions of the AFCF every other day. Irradiation at a wavelength of 254 nm, the amount of irradiated blood was 1 ml / kg. As a result, the patient's well-being improved, the symptoms of encephalopathy quickly disappeared.

Dynamics of laboratory parameters

The advantages of the proposed method of treatment in comparison with the known one are in reducing the length of hospital stay from 32.2 to -30.9 bed-days and mortality from 33% to 20.8%, improving one’s well-being, normalizing sleep, appetite, reducing fever, reduction of intoxication, improvement of laboratory parameters. The method is characterized by a complex effect on the immune system, on the broad spectrum of auto- and exoflora, responsible for the degree of epdotoxemia in patients with hepatic encephalopathy and the occurrence of bacterial complications with diffuse pores.

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marriages of the liver. The method eliminates hypocrates, characterized in that

semy and hypoxia in severe lesions to reduce mortality and shorten

the liver. The side effects and complications of the treatment are additionally administered to the irradiated

no. ultraviolet autoblood in quantity

Claims (1)

The formula of the invention with -2 ml / kg and 2-6 times per course of treatment Method of treating hepatic encephalopa with an interval of 1-5 days. by administering medicinal preparations