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The peculiarities of diagnostic and medico-surgical treatment in the intraperitoneal postoperative pathologic inflammatory adhesive processes in children


Author: Lilia Baranov
Degree:doctor of medicine
Speciality: 14.00.35 - Infantine Surgery
Year:2006
Scientific adviser: Eva Gudumac
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 8 November, 2006
Approved by NCAA on the 21 December, 2006

Abstract

Adobe PDF document0.78 Mb / in romanian

Thesis

CZU 616.34-007.253-053.2-08

Adobe PDF document 3.37 Mb / in romanian
181 pages


Keywords

adhesive mechanical intestinal obstruction, markers, adhesiolysis, viscerolysis

Summary

The study includes complex clinical data and special instrumental bioimmune and morphological investigations also.

The paper is based on the treatment and investigations of 120 children (aged from 1 month – 18 years) with intraabdominal adherent process.

The study group consists of fecaloid peritonitis pacients with acute distructive appendicitis forms, intestine acute impermeability, postoperatory intestine fissure and different intraabdominal trauma.

There were used the following clinico-instrumental research methods:

In addition to the traditional methods there were established the importance of special bioimmune tests: molecular polypeptides, neurotic substances. For the uns specific deformining of immunity in plasma B- properdine concentration, C3 complement factor, gaptoglobuline, ceruloplasmine and production speed of nitrogen oxide there were studied.

The dynamic research of these factors permit not only the establishment of the inflamatory process activity in children with adherent disease but their using in the gravity level criteria of the clinico-evolutive aspects of the disease, complication appearance, treatment efficiency and disease ontcomens.

The dynamic analysis of the concentration factors of humoral immunity of JL-1B; 6B, A interleicines give us the possibility of correlation finidings with the local intensity of inflamatory reacction and protective processes. According to the statistic analysis the mathematic model which determines the morbidity level there were established. Depending on analysis results the disease intervals there were determined. The morphological research data with un specific importance in the clinico-evolutive peculiarities establishment help the determination of polymorphy, pathomorphogenesis of the intraabdominal adherent process.

Using of diagnosis and medico-surgical tacties algorithm in different clinico-evolutive forms according to the pathologic and clinico-morphological aspects of the disease conditioned the diminuation of complications and mortality of these pacients.