Strategy optimization in the acute pancreatitis treatment
Journal Title: Хірургія України - Year 2019, Vol 0, Issue 2
Abstract
The aim — to analyze the efficacy of ethyl methylhydroxypyridine succinate (Lodixem) and the combination of ethylmethylhydroxypyridine succinate and pentoxifylline in a Ringer Lactate solution (Lodixem + Latren) in the treatment of patients with acute pancreatitis. Materials and methods. The treatment results analysis in 120 patients with acute pancreatitis was performed. Men were 67 (55.8 %), women — 53 (44.2 %). The patients’ age was from 19 to 82 years (average age — 44.23 ± 2.51 years). Patients receiving standard therapy were divided into two groups: group 1A — 30 patients who received ethylmethylhydroxypyridine succinate in addition to standard therapy, group 1B — 30 patients who received ethylmethylhydroxypyridine succinate and pentoxyphylline in Ringer’s lactate solution in addition to standard therapy. The treatment results of 60 patients with acute pancreatitis treated in the surgical department in the period from 2016 to 2018 (the control group) were retrospectively analyzed. The criterion for inclusion in the study was the presence of acute pancreatitis (Atlanta, 2013), the early stage of the disease, the exclusion criteria — severe acute hepatic or renal failure, hypersensitivity to Latren or Lodiksem in anamnesis, childhood, pregnancy, breastfeeding period. The following clinical and laboratory indicators were evaluated: peripheral blood reaction, basic biochemical parameters, electrolytes in the blood, general state on integral scales to determine the diagnostic criteria for the course of acute pancreatitis on admission to hospital (day 0) and on the 1st, 3rd and 5th day of treatment,. Results and discussion. A statistically significant decrease in leukocyte levels, leukocyte intoxication index, intoxication index and C‑reactive protein content was noted in all groups, however, the rate of decline was more pronounced in groups 1A and 1B. Ranson, Simplified Acute Physiology Score II, Acute Sepsis Severity Evaluation Scale score of patients was assessed by a statistically significant reduction in patient groups treated with ethylmethylhydroxypyridine succinate and a combination of the latter with pentoxyphylline in Ringer’s lactate solution. Conclusions. The ethyl methylhydroxypyridine succinate in combination with pentoxifylline in a Ringer’s solution of lactate reduces the appearance of intoxication and stimulates reparative processes in the acute pancreatitis treatment. At the 5th day there was a significant decrease in the ASSES scale marks (up to 6.11 ± 0.37) and on the Ranson scale ones (up to 1.8 ± 0.9 points) in patients with the proposed treatment regimen. This treatment scheme can be recommended for inclusion into the treatment protocols for patients with pancreatic inflammation.
Authors and Affiliations
V. I. Robak, D. V. Ievtushenko, O. G. Petiunin, L. O. Drana
Keywords
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- EP ID EP609155
- DOI 10.30978/SU2019-2-20
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