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Modified Membranous Plasmapheresis in Complex Treatment of Patients with Liver Failure
( B. A Saidkhanov ),( D. B Saidkhanova ),( Kh. G Khalikulov ),( K. O Mahmudov ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: One of the challenging problem in modern medicine is a viral hepatitis, which can cause acute liver failure, liver cirrhosis and even HCC. In National Centre of Surgery named after acad. V. Vakhidov, we have many been conducting a number of researches dedicated to this pathology. One of them is plasmapheresis usage in complex treatment. Aim of research: to investigate the effect of advanced method of plasmapheresis conduction to patients with liver failure to efficacy of detoxication, peroxidase oxidation of lipids and antioxidant protection. Methods: therapeutic membranous plasmapheresis treatment procedures were conducted at 60 patients, 34 of them were men and 26 were female. Mean age was 37,2 years old. Except standart therapy, which included hepatoprotectors, infusions, immunomodulators and antibiotics, patients were indicated therapeutic membranous plasmapheresis. Our method consists of plasmapheresis without initial heparinization of patient, neutral anolit was used instead of citrate and isotonic solutions (Invention patent №IAP 03988 at 20.07.2009). Results: Most patients had high levels of average molecular peptides, bile acids, ALT, AST and CPR, which considerably decreased after 3rd procedure. Conclusions: Plasmapheresis with neutral anolitis results to detoxication effect, which is presented by free radicals process recuperation and enhancement of clinical and biochemical features at earlier stages. This action is reached due to complex efferent and oxidase detoxication technologies, which in its turn approve feasibility of developed method.
Modified Extracorporal Detoxication after Pankreatic Tumor Operations
( B. A Saidkhanov ),( D. B Saidkhanova ),( Kh. G Khalikulov ),( K. O Mahmudov ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: The problem of treatment of acute postoperative pancreatitis and its complications is the complex problem after pancreatic tumor operations. Mortality rate remains high, and varies from 10% to 40%. Aim of research: to increase treatment effectiveness of patients with acute pancreatitis. Methods: A complex of an intensive care the modified technique of plasma exchange with reinfusion of detoxicated exfused blood by its indirect electrochemical oxidation is applied. Results: All patients in a reference group had strong indications of endointoxication with multiorgan failure phenomena. After completion it was succeeded to achieve the considerable decrease in practically all studied indexes from patients of both groups. However, the tendency to a normalization was more expressed at patients of evaluated group who needed carrying out smaller number of sessions of PAS. Conclusions: Neutral anolyte inclusion into technique of plasma exchange carrying out allowed us to avoid development of above-stated complications from hemostasis system and to substantially increase effectiveness detoxication. The universality of developed technique and expediency of its use was proved by the conducted researches at wide range of diseases. Thus, in all cases, irrespective of the reasons which caused the necessity of carrying out detoxication actions we managed to reduce the number of sessions, i.e. to increase quality of detoxication. Especially it is necessary to emphasize positive influence of this technique on coagulation and anticoagulative mechanisms of hemostasis that is also the basic moment for the choice of this scheme of carrying out PAS in comparison with the working standard.