ELIMINATION OF EDEMATO-EXUDATIVE CHANGES IN THE PANCREAS AND RETROPERITEN SPACE TISSUES, AS A COMPONENT OF THE TREATMENT PROGRAM IN ACUTE PANCREATITIS

Abstract

Acute pancreatitis is the main type of gastroenterological pathology with an incidence of 13–45 cases per 10 000 population, with 270 000 patients requiring hospital care. The clinical course of edematous-interstitial AP and aseptic pancreatic necrosis is accompanied by the development of edema of pancreatic tissues and fatty tissue of the retroperitoneal space, which require leveling.Purpose of the work. To develop a scheme for the medical treatment of edema and edematous-exudative lesions of the pancreas and soft tissues of the parapancreatic retroperitoneal space in patients with acute pancreatitis.Materials and methods. The study was conducted in 64 patients aged 37 to 69 years with interstitial-edematous and aseptic-necrotic forms of acute pancreatitis with existing edema of pancreatic tissues and retroperitoneal space. The diagnosis of the disease was established on the basis of the assessment of clinical, laboratory-biochemical and radiological (ultrasound, CT) examination methods. Patients of the main group (38) were prescribed diosmin-hesperidin-containing drugs of the flavonoid group according to the original method. Conventional treatment was used in the comparison group (26). Clinical and laboratory data, results of dynamic ultrasonography, tests for tissue hydrophilicity, the presence of asepticity/infection of the inflammatory process were taken into account in the assessment of the effectiveness of the treatment.The determination was carried out in dynamics – on the 1st, 3rd and 5th day from the start of treatment. The calculation of the average values was carried out in the form of an arithmetic mean with a standard error (M ± m). The Student’s test was used, with the difference at P < 0,05 being considered statistically significant.Results. Positive dynamics of clinical manifestations of the disease, leukocytosis level and local hydro- philicity of tissues in the main group of patients were noted. According to ultrasonography, a statistically significant decrease in the size of edema of the head, body (already on the third day) and tail of the pancreas (on the fifth day), as well as anterior-posterior and upper-lower indicators of edematous-exudative changes in the peritoneal space tissue was observed. Asepticity of inflammation was preserved in 74% of cases. A treatment algorithm for aseptic pancreatic necrosis using anti-edema therapy and interventional ultrasonography is proposed.Conclusions. Anti-edematous drug therapy is an important component in the treatment of edematous-interstitial and aseptic-necrotic forms of acute pancreatitis.