[Immunotherapy of surgical sepsis].
The results of treatment of 73 patients with surgical sepsis are analysed. 57% of the patients were older than 60 years. In 35.6% of the cases sepsis was caused by soft tissue infection, in 35.6%-pyo-inflammation of the blood vessels. In 81% of the cases infective agents were verified; in 45.2% they were found in associations. In 35.1% of the cases there were gram-positive microorganisms, in 40.5%-gram-negative and in 17.0%-asporogenic anaerobes. The count of T- and B-lymphocytes was low (60.0% and 45.7%), the count CD4 was decreased in 40.2% of the patients, CD8-in 31.6%, the content of M-and G-immunoglobulins was also decreased on a background of a slightly increased CD3-activator. Polyorganic insufficiency has been detected in all the patients, predominantly-kidney and liver insufficiency. Septic metastases were detected in 26% of the cases, septic shock-10%. Early treatment of abscesses, adequate antibacterial and detoxication therapy are major tasks in the treatment of sepsis. Intravenous injections of immunoglobulins (Endobulin., Intraglobin and Pentaglobin), extracorporeal detoxcication and polyorganic disorders correction have led to positive results in most cases. The mortality rate in this group was 14.5% compared with 38.5% in the control group.
Malinovskii
N N
NN
Medical Center of President's Managing Department, RF, Moscow.
Reshetnikov
E A
EA
Shipilov
G F
GF
Vivitskaia
I M
IM
Tsibin
V I
VI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D018805:Sepsis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate
D016756:Immunoglobulins, Intravenous