Influence of Lymphostimulatinginjections on the Course of Reperfusion Syndrome Arose after Surgical Lower Extremity Мesselsrevasculization


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Abstract

Relevance One of the most serious complications of surgical lower extremity revasculization is reperfusion syndrome, that prevention and treatment is both scientific and practical problem. Even partial blood flow restoration leads to penetration of injure tissue metabolites into the circulating course and results in change of acid and main condition of blood indexes. Actually there is no uniform tactics for treatment of reperfusion syndrome taking into account functional condition of lymphatic system drainage function and possibility of its strengthening

The purpose of the study To reveal the capabilities of lymphostimulating injections for reduction of the reperfusion syndrome expression at patients with chronic ischemia of low extremities in postoperative period.

Materials and methods 84 patients with atherosclerotic occlusion of femoral- popliteal segment after surgery in connection with life-threatening chronic ischemia were explored. The acid-base blood status indexes were investigated before surgery and on the 1th, 3th and 7th day after surgery at all patients. All patients were split up on 2 main groups: after femoral - proximal popliteal bypass or prosthetics and after femoral - distal popliteal bypass or prosthetics. Control group and research group were singled out in every main group.  Patients from control groups in postoperative period were treated in standard way. Patients from research groups in postoperative period were treated in standard way and by lymphostimulating injections in addition.

Results and their discussion By results of the study all patients from control groups had elevated level of blood pH value. In research groups blood pH value did not exceed critical exponent at all stages of observation. All patients from groups with lymphotropic injections had lower indexes of carbon dioxide level versus patients with standard treatment.  Also in research groups the severity of the operated limb edema was significantly lower than in control groups. Frequency of lymphorrhea appearance at patients from control groups was authentically higher than at patients from research groups. Hereby significant decrease of the reperfusion syndrome symptoms expression was detected at patients in research groups that is most probably caused by positive impact of  lymphostimulating  therapy on regulatory movements providing homeostasis of liquid system and tissue agents.

Conclusion In the present study the possibility of lymphostimulating injections using is shown to reduce the severity of the reperfusion syndrome. Further to standard treatment lymphostimulating injections helped to retain the acid-base status within acceptable parameters. More pronounced effect was found in the study of extremity reperfusion edema that indicated activation of lymphatic system drainage function.

About the authors

Novosibirsk State Medical University, Novosibirsk, Russian Federation;Novosibirsk Regional Clinical Hospital, Novosibirsk, Russian Federation

Author for correspondence.
Email: barakudao@mail.ru
Surgeon of the vascular surgery department of the novosibirsk State regional clinical hospital

Novosibirsk State Medical University, Novosibirsk, Russian Federation

Email: chikinev@inbox.ru
PhD, prof. the head of the department of hospital surgery of the novosibirsk State Medical university

Novosibirsk Scientific research Institute of clinical and experimental Lymphology, Novosibirsk, Russian Federation

Email: lymphology@soramn.ru
PhD, prof. acting director of novosibirsk Scientific research Institute of clinical and experimental Lymphology in scientific-research work, PhD, prof., corresponding Member of the russian Medical Academy of Sciences

Novosibirsk Regional Clinical Hospital, Novosibirsk, Russian Federation

Email: barakudao@mail.ru
Head of the vascular surgery department of the novosibirsk State regional clinical hospital

Novosibirsk Regional Clinical Hospital, Novosibirsk, Russian Federation;Novosibirsk State Medical University, Novosibirsk, Russian Federation

Email: dirksenpetr79@gmail.com
Surgeon of the vascular surgery department of the novosibirsk State regional clinical hospital

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