Vlasov A P, Zaitsev P P, Vlasova T I, Okunev N A, Sheyranov N S, Bolotskikh V A, Muratova T A
National Research Mordovia State University. N.P. Ogarev, Saransk, Russia.
Khirurgiia (Mosk). 2019(3):73-79. doi: 10.17116/hirurgia201903173.
The purpose of the study was to establish the effectiveness of Remaxol in restoring tissue reparative ability of laparotomy wound in acute severe pancreatitis.
The work is based on the results of experimental and clinical studies. Experiments were carried out using acute total pancreatic necrosis model under anesthesia on 30 dogs. Furthermore, 28 patients with acute severe pancreatitis were examined and underwent surgery on various purulent-necrotic complications. In the postoperative period, healing and metabolic processes were evaluated in the tissues along the sutures line of the laparotomy wound. Also, such parameters as endogenous intoxication, oxidative stress, and phospholipase activity were evaluated at the organism level. In the studied groups, Remaxol is included in the postoperative therapy.
It has been established that during acute severe pancreatitis reparative potential of tissues is significantly reduced, which is caused by a significant disruption of trophism, activation of phospholipases and peroxidation of membrane lipids. Disorders of homeokinesis at the organism level play a negative role in tissue reparative potential reduction. Inclusion of Remaxol in the complex therapy of acute pancreatitis leads to a decrease in duration of wound healing by reduction in the phase of inflammation. Optimization of the healing process occurs due to complex effect of the drug at organ and body level, which results in improvement of the trophism and, what's more, stabilizes membranes of regenerating cells.
In case of acute severe pancreatitis, the use of Remaxol in early postoperative period in the complex therapy leads to a significant correction of factors that adversely affect regeneration and contributes to the restoration of tissue reparative potential.
本研究旨在确定瑞马索（Remaxol）在恢复急性重症胰腺炎剖腹手术伤口组织修复能力方面的有效性。
本研究基于实验和临床研究结果。在30只麻醉状态下的犬身上，利用急性全胰腺坏死模型进行实验。此外，对28例急性重症胰腺炎患者进行检查，并针对各种化脓性坏死并发症进行手术。在术后阶段，评估剖腹手术伤口缝线处组织的愈合和代谢过程。同时，在机体水平评估内源性中毒、氧化应激和磷脂酶活性等参数。在研究组中，瑞马索被纳入术后治疗。
已确定在急性重症胰腺炎期间，组织的修复潜能显著降低，这是由营养障碍、磷脂酶激活和膜脂过氧化的显著破坏所致。机体水平的内环境稳定紊乱在组织修复潜能降低中起负面作用。在急性胰腺炎的综合治疗中加入瑞马索，可通过缩短炎症期来减少伤口愈合时间。愈合过程的优化是由于该药物在器官和机体水平的综合作用，这导致营养改善，更重要的是，使再生细胞的膜稳定。
在急性重症胰腺炎的情况下，在术后早期的综合治疗中使用瑞马索可显著纠正对再生产生不利影响的因素，并有助于恢复组织修复潜能。
