The aim: To assess of pro-inflammatory IL-8 and anti-inflammatory IL-10 serum concentration in patients with T2DM with intraabdominal postoperative abscesses in perioperative period. Materials and methods: The 48 participants, aged 40 – 75 years, among them 24 males and 24 females. All patients were divided into groups: group 1 – 12 patients with T2DM and intra-abdominal postoperative abscesses, group 2 – 12 patients without T2DM but with intra-abdominal postoperative abscesses and 24 healthy individuals. The level of IL-8and IL-10 serum was determined on the day before surgery, on the 2-3rd and 5-7th day after surgery in patients with type 2 diabetes and intra-abdominal postoperative abscesses. Results and conclusions: The trajectories of the level of interleukins in patients with type 2 Diabetes mellitus were different from the trajectories of their level in patients without diabetes, which indicates a special immune response to nosocomial infection and surgical trauma. The mechanism of changes in serum levels of IL-8 and IL-10 in patients with type 2 Diabetes mellitus and postoperative intra-abdominal abscesses should be further studied in future studies on the specific causative agent of nosocomial infection and the cytokine response to it.
Summary. The aim of the work was to compare the results of surgical treatment of patients for postoperative abdominal abscesses using different tactics. Materials and methods. The study included data from 63 patients with postoperative abdominal abscesses. Laparotomy access and use of percutaneous puncture / drainage were compared. Kaplan-Meier survival analysis was used to compare hospitalization duration. Results. Laparotomic access was performed according to classical methods. After the application of general anesthesia and treatment of the surgical field was performed opening the anterior abdominal wall. The abscess was opened and the contents were aspirated, after treatment of the cavity site with aqueous solutions of antiseptics, the wound was closed and the drainage system was established. Further stages of treatment of intra-abdominal abscess after routine surgery were: aspiration of abscess in the postoperative period through established drainage; diagnostic control of abscess resolution; effective antimicrobial and detoxification therapy. Percutaneous puncture / abscess drainage was performed under ultrasound control using special puncture needles of size F8 - F12. The needle or drainage stlet-catheter was inserted into the abscess cavity, followed by aspiration of the abscess contents and leaving the drainage system. Kaplan-Maier has reduced hospitalizations in patients who have used mini-invasive technologies. Conclusions. Treatment of postoperative abdominal abscesses involves a surgical approach. Patients with postoperative abscesses who underwent laparotomy access were likely to have an increased total hospitalization duration of 5 days compared with the use of mini-invasive technologies.
Intra-abdominal infections (IAI) are associated with high levels of pro-inflammatory serum IL-8 and poor outcomes, but data on IL-8 levels in various inflammatory reactions are contradictory. A better understanding of the diagnostic role of IL-8 is important, since the clinical relevance remains unclear. Methods: That was a single-center observational longitudinal cross-sectional study included 56 patients with various origins of intra-abdominal infections: 24 patients with postoperative abscesses, 12 patients with primary intra-abdominal abscesses, and 20 patients with diffuse peritoneal collection. Perioperative serum concentrations of interleukin-8 IL-8 were investigated at the day before surgery, on the 2nd–3rd day, and on the 5th–7th day after surgery. The hypothesis suggested that there was a difference in serum IL-8 in patients with IAI of different origin in the perioperative period. Results: The study showed that the level of serum IL-8 in patients with intra-abdominal infections of different origins is lower in comparison with healthy individuals. Despite the fact that we did not detect any statistically significant differences in the level of IL-8 in serum in IAI of different origin in the perioperative period, its lowest index was observed in the patients with postoperative abscesses on the 5th–7th days after surgical intervention. The levels of serum IL-8 ≤49.71 pg/mL and ≤48.88 pg/mL may serve as diagnostic markers for primary and postoperative abscesses with significant sensitivity and specificity. Conclusions: Our results differ from previous studies that showed high serum IL-8. High-quality clinical trials are needed to better comprehend the role of inflammatory mediators in IAI with different origin.
Метою роботи було вивчення перебігу внутріш-ньочеревнних інфекцій з урахуванням призначення сучасної емпіричної антибактеріальної терапії. Проаналізовано матеріали 27 пацієнтів з внутріш-ньочеревними інфекціями. Визначено, що частіше реєструвалася E.coli у поєднанні з стрептококами, стафілококами, ентерококами та Р.aerugenosa. У всіх пацієнтів був перитоніт, у 22,2% розвинулися післяопераційні ускладення незважаючи на приз-начення сучасної емперічної терапії у комбінації цефалоспоринів або фторхінолонів з метронідазо-лом. Ускладення реєструвалися у пацієнтів старше 60-річного віку з коморбідними станами. Автори вважають доцільним застосування міні-інвазивних технологій для лікування післяопераційних усклад-нень, оскільки релапаротомії удорожнювали ліку-вання за рахунок додаткового призначення антиба-ктеріальних засобів та тривалого перебування в хірургічному стаціонарі.Ключові слова: інтраабдомінальні інфекції, ускладнення, антибактеріальна терапія.Зв'язок роботи з науковими програмами, планами, темами. Дана робота є фрагментом НДР «Удосконалення та розробка методів діагнос-тики та хірургічного лікування захворювань і травм органів черевної порожнини та грудної клітки, су-дин верхніх та нижніх кінцівок із використанням міні -інвазивних методик у пацієнтів на високий ризик розвитку післяопераційних ускладнень», № держ. реєстрації 0116U004991.Вступ. Внутрішньочеревної інфекції виникають внаслідок порушення нормального бар'єру слизо-вої оболонки шлунково-кишкового тракту, що до-зволяє нормальній флорі кишечнику потрапити до черевної порожнини, переважно колі формним бак-теріям (Escherichia coli, Klebsiella spp, Proteus spp. і Enterobacter spp.) стрептококам, ентерококам та анаеробним бактеріям. Кишкова флора складаєть-ся приблизно з 400 видів, але в середньому від чотирьох до шести видів є збудниками внутріш-ньочеревних інфекцій. Домінуючими ізолятами більшості є Bacteroides fragilis та E. coli [2,3,7,8]. Існує безліч факторів, які сприяють цьому явищу,
Objective. To assess the blood serum IL-10 concentration in patients with intra-abdominal infections. Materials and methods. Clinical specimens were obtained from 56 patients, suffering intra-abdominal infections of various origin: 24 patients - with postoperative abscesses, 12 - with primary intra-abdominal abscesses, and 20 - with diffuse or local peritoneal collection at the day before surgical intervention, on 2nd-3rd day and on 5th-7th day after it. Results. There was no trustworthy difference established between the blood serum IL-10 concentrations in patients with different origin of intra-abdominal infections in perioperative period. The significant difference was established, while comparing concentrations of IL-10 in the blood serum in patients with intra-abdominal infections before and on the days 2-3 and 5-7 postoperatively, and in healthy persons. Conclusion. Concentration of the blood serum IL-10 ≥ 6.78 pg/mL in patients with different origin of intra-abdominal infections has significant prognostic significance: sensitivity (92.86%) and specificity (80.65%). Further studies, targeting a specific causative agent of nosocomial infection and the cytokine response, are needed.
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