OPTIMIZATION OF THE MEDICAL CARE TO WOMEN WITH POSTPARTUM PURULENT-INFLAMMATORY DISEASES ON THE BASIS OF THE PATHOGENETIC MODEL
DOI:
https://doi.org/10.11603/24116-4944.2021.1.12351Keywords:
purulent-inflammatory diseases, sepsis, pathogenetic model, method of fluorescence spectroscopyAbstract
The aim of the study – to use the pathogenetic diagnostic and treatment model for purulent-inflammatory diseases and sepsis within the method of fluorescence spectroscopy.
Materials and Methods. Blood serum (BS) of the patients of the main group – 40 pregnant women, 180 women with postpartum endometritis and 15 patients with sepsis and control group – 40 healthy women with uncomplicated postpartum period. Research methods: clinical, laboratory, biochemical, instrumental, method of fluorescence spectroscopy, mathematical and statistical.
Results and Discussion. In healthy people the fluorescence spectra of BS have the form of lambda-like curves with λmax in the range of 330.1–335.1 nm, corresponding to the normal glow of human serum albumin. In patients with purulent-inflammatory diseases part of its binding centers are blocked by toxins, so there are two types of albumin molecules in the BS: "normal" and "pathological". For pregnant women, the fluorescence intensity of BS increases by no more than 30 % compared with the characteristics of 20 % albumin solution, the values of which were taken as a standard. Shift of λmax was not detected for women in the control group. The fluorescence intensity is in the range of more than 0.81 relative units (r.u.) compared to IF of 20 % donor albumin. For women with postpartum endometritis, a decrease in the fluorescence intensity of the BS below 0.81 r.u. and in particularly severe cases – a smooth long-wave shift of the fluorescence spectrum were detected. For patients with sepsis the decrease in fluorescence intensity by 70–80 % of normal was detected. In particularly severe cases, second peak appeared in the long-wave region.
Conclusions. The pathogenetic model of purulent-inflammatory diseases and sepsis was proposed. Its effectiveness was substantiated on the basis of research of spectral-fluorescent characteristics of blood serum of patients with purulent-inflammatory diseases and sepsis. The use of albumin solution in the complex treatment of postpartum purulent-inflammatory diseases and sepsis was proposed.
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