Perm', Perm, Russian Federation
Perm', Perm, Russian Federation
Perm', Perm, Russian Federation
Perm', Perm, Russian Federation
Predmet. Nesmotrya na shirokoe izuchenie gnoynoy patologii, ostaetsya ryad nereshennyh problem pri lechenii flegmon lica. Zachastuyu takie zabolevaniya protekayut na fone drugih obschesomaticheskih patologiy, a ih vzaimnoe vliyanie izucheno slabo. Takie sostoyaniya soprovozhdayutsya razvitiem endogennoy intoksikacii, pri kotoroy narushaetsya gomeostaz, a takzhe proishodit rasstroystvo deyatel'nosti zhiznenno vazhnyh organov i sistem organizma pacienta. Cel' — ocenit' vyrazhennost' endogennoy intoksikacii u pacientov s flegmonoy lica na fone komorbidnoy patologii. Materialy i metody. Obsledovali 82 pacienta s ustanovlennym diagnozom «gnoyno-vospalitel'noe zabolevanie chelyustno-licevoy oblasti» (L03.2), a takzhe 26 prakticheski zdorovyh dobrovol'cev. Ispol'zovali kompleks leykocitarnyh indeksov dlya ocenki stepeni endogennoy intoksikacii. Vsem pacientam provedeno klassicheskoe bakteriologicheskoe issledovanie otdelyaemogo flegmon. Rezul'taty. Pri izuchenii struktury etiologicheskih agentov, vydelennyh iz otdelyaemogo flegmon, ustanovleno, chto u pacientov s nizkimi pokazatelyami endogennoy intoksikacii preobladayut predstaviteli roda Staphylococcus, a u pacientov s vyrazhennoy endogennoy intoksikaciey — Streptococcus. Pokazano, chto bolee 40 % pacientov s flegmonami i komorbidnoy patologiey imeyut priznaki endogennoy intoksikacii. Pri sochetanii flegmony lica i hronicheskogo pielonefrita leykocitarnyy indeks intoksikacii sostavil 7,2±1,7 u.e. (p<0,05), pri sochetanii s gipohromnoy anemiey — 3,1±0,7 u.e. (p<0,05), pri sochetanii s gepatitami — 2,9±0,7 u.e. (p<0,05), a v kontrol'noy gruppe — 0,6±0,01. Krome etogo, u vseh pacientov s komorbidnoy patologiey snizhen indeks rezistentnosti organizma, chto ukazyvaet na neobhodimost' detoksikacionnoy terapii. Vyvody. Flegmona lica, protekayuschaya na fone komorbidnoy patologii, harakterizuetsya nalichiem endogennoy intoksikacii, kotoraya mozhet byt' obuslovlena kak narusheniem vyvedeniya toksinov, tak i povyshennym ih obrazovaniem.
flegmona lica, endogennaya intoksikaciya, komorbidnaya patologiya, leykocitarnyy indeks intoksikacii, hronicheskiy pielonefrit, gipohromnaya anemiya
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