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influence intraperitoneal himiogipertermicheskoj perfusions on the basis of the minimum extracorporal contour on secretory system of an organism

Volume of a cytoreductive stage of operative treatment, and also the subsequent VHGP demand much of criteria of estimation OTSK. Along with measurement TSVD, the constant control of a diuresis provides a feedback of efficiency of an intensive care.

All patient for complex treatment (operation +

himiogipertermicheskaja perfusion) and in the first days of the postoperative period the urinary catheter for the purpose of the diuresis control was established.

In table 25 data of an hourly average diuresis before operation, during VHGP on the basis of the minimum extracorporal contour and in the early postoperative period are presented. In this table data of volume of infusional therapy during the corresponding periods also are cited. The volume of infusional therapy during operation has made 1760+25 ml. Infusional therapy with use of diuretics was applied to reduction of nephrotoxic effect of Cisplatinum.

Table 25

Hourly diuresis and infusional therapy at patients of the basic group at

Performance of complex treatment

The research period Hourly diuresis (ml/hour) Volume infusions (ml/hour)
Before operative treatment 101+6,50 714+50
In a cytoreduction + VHGP 98+10,70 1760+25
The first days after operation 110+7,30 125+15

The note: VHGP - intraperitoneal himiogipertermicheskaja perfusion

For the purpose of the control of function of kidneys at all patients besides clinical research of urine, in the postoperative period assay Reberga was carried out. Against VHGP c application of the minimum extracorporal contour the augmentation of volume of infusional therapy did not lead to the expressed augmentation of a daily urine, the creatinine clearance decreased. However at patients of the basic group after operation both indicator came nearer to the third days to dooperatsionnym to value.

Changes of indicators of function of kidneys, thus, have not been expressed, had short-term and reversible character. Basically they have been bound to initial insignificant disturbance of function of kidneys and with spent infusional medicamental support. At 6 (24 %) patients of the basic group have been found out changes in indicators of the general analysis of urine in the early postoperative period. These changes were shown by depression of a specific gravity of urine, augmentation of the maintenance of fiber in urine and occurrence of individual cylinders, an epithelium and leucocytes. At 3 (12 %) from these patients were available implications of acute renal insufficiency of easy degree which were shown by moderate depression of a diuresis, rising of level of urea and a creatinine.

Deviations of indicators of the general analysis of urine remained till 4 days and independently came back to normal indicators by the period of an extract from a hospital. Hydration of an organism and maintenance of high level of a diuresis were preventive maintenance effectual measures

Nephrotoxic action of Cisplatinum at carrying out VHGP on the basis of the minimum extracorporal contour.

Thus, VHGP on the basis of the minimum extracorporal contour with application of Cisplatinum possessing the proved

Nephrotoxic effect, did not render essential influence on diuresis level, concentration and secretory functions of kidneys.

5.3.

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A source: ALEKSEEV Valentine Valerievich. IMPROVEMENT OF THE HYPERTERMAL CHEMIOPERFUSION METHOD IN THE SYSTEM OF COMPLEX TREATMENT OF PATIENTS WITH BERUSHINA CARICOMATOSIS. Thesis for the degree of candidate of medical sciences. St. Petersburg 2015. 2015

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