Effectiveness of Lymphotropic Therapy in the Patients With Acute Appendicitis and Its Complicated Forms

Abstract

Introduction. Despite using the latest generations of antibiotics and modern methods of their introduction in the surgical treatment of acute appendicitis, purulent-septic complications keep occurring, accounting for 45% of fatal outcomes in the patients operated on for this disease. Materials and methods. Patients were divided into two groups. The main group included patients who were administered antibiotics and pathogenetic drugs locally to the ileocecal zone by means of lymphotropic administration. The comparison group included patients who received standard antibiotic therapy. Results. On the 5th day of the postoperative period, the level of IgA in the main group was 1.16 ± 0.7 mg/ml, and in the comparison group – 1.54 ± 0.8 mg/ml. The level of elastase in the operated patients of the main group decreased to 111.797 ± 21.39 nmol/min × ml, i.e., by 2.4 times (p <0.001), and in patients of the comparison group – to 179.605 ± 26.79 nmol/min × ml, i.e., by 1.5 times (p <0.05). Under the influence of lymphotropic administration of the antibiotic, the volume of the spleen decreased by the 5-th day to 281.22 ± 18.8 cm³, i.e., 145.44 cm³, and with standard administration of antibiotics, the spleen decreased within the period to 344.71 ± 21.13 cm³, i.e., by 79.54 cm³, which is less by 66 cm³, or 1.8 times (p <0.05) vs. main group. Conclusions. The proposed method of antibiotic therapy is a preventive measure against purulent-septic complications, especially in its destructive forms, improves the results of treatment of patients with acute appendicitis, and shortens their term of staying in the hospital, which has a positive impact on financial status.