A.B.Gavrilik, I.G.bug, B.L.Gavrilik the Grodno state medical university

Dynamics of microelements’ (zinс, copper) contents in adhesions in abdomen A.B. Gavrilik, I.G. Zhuk, B.L. Gavrilik Formation of solderings in a belly cavity at patients by whom are executed abdominalnye operations, can serve as the reason of some complications the postoperative period. Most terrible of them - adhesive intestinal the impassability creating high percent letalnosti and leading repeated laparotomii [2]. However is far often not at all patients after operation on bodies of a belly cavity solderings are formed. According to many authors [2, 3], formation of solderings after operations is caused by individual predisposition to development srashchenij. At the present stage of development of surgery are developed new, more effective ways of preventive maintenance of formation vnutribrjushinnyh srashcheny, based on laparoskopicheskom division of solderings in early terms of the postoperative period. However laparo-skopicheskaja operation is unsafe and demands strict indications to to performance. In this case special value gets group allocation patients with the raised propensity to formation srashcheny for conducting active tactics in the postoperative period. Allocation of such group can be promoted by working out prognosticheskih criteria of activity spajkoobrazovanija on the basis of studying of level of the bioagents participating in processes spajkoobrazovanija and reparatsii. Certain interest in this respect represents studying of level some microcells (zinc, copper) which as a part of various fermental systems participate in reparation processes, kollageneza, antioksidantnoj protection organizma. We have studied dependence of level of microcells (zinc, copper) from activity spajkoobrazovanija. Research is executed on experimental and clinical a material. As object 24 males of white not purebred rats were used. Modelling spajkoobrazovanija a belly cavity of 4 ml/kg weights of a body spent by vnutribrjushinnogo vve-denija 0,25 % of a solution gljutarovogo aldehyde in a dose. Animals acted in film from experience on 2, 6, 14 days under radio a narcosis. Presence of solderings was ascertained visually and proved to be true gistologicheski. Blood for research got. Then were spent clinical researches by 50 sick sharp adhesive intestinal impassability, from which two groups have been generated: operated (n=30) and patients, at which impassability managed to be resolved conservative by (n=20). Control group have made practically healthy 20 chelovek. Concentration of zinc and copper in blood defined by means of a method nuclear absorptions on atomno-absorbtsionnom spektrofotometre "Saturn-2". Results of modelling spajkoobrazovanija are presented on fig. 1, clinical researches in group of the operated and not operated patients - on fig. 2 and 3. Apparently on fig. 1, zinc level in blood whey for 2 days after modelling it is authentically lowered in comparison with its level at patients control group (0,148±0,017) and makes 0,076±0,01 mg / %. On 6 and 14 days the tendency to increase of its level - 0,092±0,007 and 0,093±0,007 accordingly is observed. It is possible to note also the expressed decrease in level copper by 2nd days in comparison with the control - 0,08±0,012 and 0,18±0,041 accordingly. On 6 and 14 days the copper maintenance authentically increases on to comparison with the second days (0,171±0,024 and 0,198±0,017), coming nearer to to values control gruppy. Decrease in level of zinc and copper by 2nd days after modelling testifies to an intoxication of an organism which is shown, in particular, disbalansom ions the internal environment of an organism. Eventually level of microcells is stabilised, however values of zinc remain lower in comparison with the control. This tendency negatively affects reparation processes (at all animals on opening the expressed adhesive process is found out). Copper level is quickly restored, providing by means of action tseruloplazmina antitoxic function organizma. In clinical group of the operated patients (fig. 2) zinc level at receipt is authentically raised (0,215±0,021 mg / %). For 1 days after operation the tendency to the further increase of its concentration (0,258±0,057 mg / %) whereas by the moment of an extract indicators of the maintenance of zinc decrease (0,167±0,02 mg / %) is observed. The copper maintenance in blood whey in comparison with control group is authentically lowered (accordingly 0,122±0,015 and 0,071±0,011 mg / %). In the course of treatment the tendency to its increase concentration is observed, and before an extract the maintenance authentically differs in comparison with indicators at receipt (0,095±0,012 the mg / %), however does not reach values of control group. In group of patients at which impassability is resolved conservatively, the similar tendency (fig. 3) is observed. Zinc level is raised at receipt in a hospital (0,195±0,02 mg / %) and authentically decreases before an extract (0,147±0,048 mg / %). The copper maintenance at receipt also much more low, than in to control group (accordingly 0,122±0,015 and 0,07±0,005 mg / %), and before an extract raises (0,096±0,012 mg / %). It is possible to assume, that revealed at the analysis of the received data of fluctuation zinc level in group of the operated testify to stimulation of processes reparations in reply to intestinal impassability and following for it operational a trauma. Increase of its maintenance at receipt is, certainly, the answer on the stressful influence, which reason - in developing intestinal impassability. Further operative intervention, eliminating the reason impassability, in itself leads to massive damage of fabrics and to aggravation of processes of a reparation. In this case zinc emission in blood whey - kompensatornaja the reaction stimulating in further reparativnye the processes. Besides, increase of the maintenance of zinc in blood whey activates immune system, strengthens emission interlejkina-1, stimulates T-limfotsity and mononuklearnye phagocytes [7]. In process of approach rekonvalestsentsii activity processes of healing and immunogeneza decreases, that leads to decrease zinc level before an extract from statsionara. Important influence on fluctuations of level of zinc and copper can have also the factor ionic disbalansa, called by pathogenetic changes at intestinal impassability. However dynamics of level of zinc and copper in both groups carries similar character though intoxication degree in group operated, it is unconditional, above. Thus, level of the specified microcells does not depend on expressiveness of an intoxication. In group of not operated patients of change of the maintenance of zinc in whey blood have similar character and correspond to dynamics of changes stress - adaptatsija. Level of copper which also should correspond to the general rekonvalestsentnoj to dynamics of an organism (increase at receipt and decrease at the moment of an extract from a hospital), on the contrary, at receipt it is considerably lowered and does not reach indicators of group healthy even before an extract. maintenances of copper both in group of the operated patients, and at not operated patients it is not obviously possible to explain similar decrease in indicators from a position of the changes called by stressful influence as dynamics of changes in both groups is practically identical, despite various degree of an intoxication. as Acknowledgement to it is served by high level of copper in the control group patients who also have transferred simple operative vmeshatelstva. According to a number of authors [ 4], fluctuations of level of copper can be connected also with a painful syndrome, however in this case is observed giperkupremija. Anyhow, decrease in level of copper in blood whey is neblago-is pleasant affects processes immunogeneza and peritonealnoj reparations. Deficiency of copper negatively influences function tseruloplazmina. In particular, decreases it ability to inaktivatsii serotonina and gistamina [1], according to some information [5, 8], playing the important role in patogeneze spajkoobrazovanija. Maintenance reduction copper calls oppression fagotsitarnoj activity nejtrofilov and proliferativnogo the cellular answer, concentration decrease interlejkinov [1, 6]. the copper Lack is one of pathogenetic links of reaction fast atsetilirovanija, that leads to superfluous synthesis of collagen embrionalnogo type and to the accelerated growth of a connecting fabric [2, 3]. Thus, fluctuations of the maintenance of zinc and copper in blood whey experimental animals and sick of adhesive intestinal impassability carry various character. It testifies that processes of a reparation and immunogeneza at artificial modelling spajkoobrazovanija and at repeated formation of solderings at the patients, suffering adhesive illness, proceed differently. Changes of the maintenance of zinc and copper in clinical group do not depend on intoxication degree. Increase of concentration of zinc after a trauma and stressful influence displays high activity reparativnyh processes in an organism of patients with repeated spajkoobrazovaniem. However dynamics of changes copper level mismatches normal rekonvalestsentnoj to dynamics. gipokupremija has proof character, it is expressed at receipt and it is saved on the moment of an extract both in group operated, and in group not operated patients. 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