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[Diagnosis and treatment of septicemia].

作者信息

Malinovskiĭ N N, Reshetnikov E A, Shipilov G F, Tsibin V I

出版信息

Khirurgiia (Mosk). 1992 Jul-Aug(7-8):3-8.

PMID:1469867
Abstract

There were 52 patients with sepsis, 61.6% were over 60 years of age (63.3% of patients had septicemia, 36.7% had septicopyemia). The disease was caused by ++pyo-inflammatory diseases of the vessels in 34.6% and the urinary system in 17.3% of cases. Microbial causative agents were isolated from the blood in 83.3% of patients (monoculture in 46.6%, associations of microorganisms in 36.6%; staphylococcus in 59.7%, gram-negative microflora in 46.7%). The most frequently encountered disorders of the immunological status were reduction of the number of lymphocytes and their T- (85%) and B-population (62.9%), increase of the level of immunoglobulins M (81.5%) and A (55.6%), decrease of the number of accessory T-cells (73.6%) and the ratio of accessory and suppressant T-cells (52.6%). Along with the application of antibacterial therapy, which relieved the microcirculatory blockage, and detoxication measures in the treatment of the purulent foci, much attention was paid to immunologic correction for the removal of primary and secondary insufficiency (endobulin, ++T-activin, isoprinosin). Blocking of the immunological reaction was relieved in 65.5% of patients by discrete plasmapheresis with compensation for the deficiency with endobulin, quick-frozen plasma, and rheopreparations. In the group of 52 patients 12 died (mortality 23.1%).

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