Peritonitis is one of the most severe complications of diseases and damages of the abdominal cavity and is steadily occupying a leading place in the structure of surgical lethality, which varies from 1.3% in local and to 80% indisseminated purulent peritonitis, in the toxic and terminal stage of purulent peritonitis – 25-30%, in case of progression of multiple organ failure syndrome – 60-87% of cases. Today, a new innovative solution of “Neoreodez” that represents a 0.06% solution of sodium hypochlorite stabilized with taurine (2-aminomethansulfonic acid) with the reproduction of N-chlorateurin (N-chloro-2aminomethansulfonic acid), stable in vitro, but unstable (disassociated with sodium hypochlorite and taurine) in vivo. This medicinal product contributes to reducing the toxic and metabolic load on the organs of excretion and detoxification, and also corrects metabolic processes, which can significantly reduce the severity of endotoxicosis and avoid its chronization and related complications. Also, the drug has a moderate antimicrobial action in vitro, stimulates reparative processes in the body, while not exposing the irritant to the skin and mucous membranes. In addition, the solution “Neoreodez” shows a clear anti-aggregate activity, while not causing changes in the gas transport function and changes in the acid-alkaline state in the blood. The objective of this work was to establish the clinical efficacy of the drug “Neoreodez”, which is used in the background of basic therapy in patients with acute peritonitis compared with the group of patients receiving baseline therapy. The clinical trial included patients aged 19 to 65 who were urgently taken to a clinic with manifestations of acute abdomen and patients who were performed planned surgery with subsequently occurrence of peritonitis. The duration of symptoms of peritonitis before the patients were admitted to the clinic was from 3 to 35 hours. Postoperative peritonitis (general causes of inadequacy of anastomosis, inadequate sanitation of the abdominal cavity, inadequate hemostasis, intraoperative tissue injury) developed from 24 to 72 hours after surgical intervention. As a baseline therapy, all patients obtained parenteral antibiotics, taking into account the sensitivity of the microflora, analgesics, anticoagulants, and, if necessary, prokinetics. As a detoxification therapy patients were given crystalloids, reamberine 400 ml once a day, DEK 400 ml once a day, Lotr 200 ml once a day. In addition, study group of patients were intravenously administered the drug “Neoreodez”, which was drip slowly at a rate of 20-40 dpi/min (approximately 3-3.5 ml/min) per 400 ml twice daily for 12 hours within 3 day. To evaluate the degree of endogenous intoxication, the method of determining the average mass molecule was used. The estimation was carried out with spectrometry in different modes of X = 254 nm and X = 280 nm. It was found, that after the completion of treatment, 49 (94.2%) patients in the study group and 26 (52.0%) patients in the control group were reduced the average mass molecule level at X = 254 nm and the average mass molecule level at X = 280 nm by 35% and more than the baseline. Thus, the effectiveness in the study group of patients receiving the drug “Neoreodez” was 94.2%, which is significantly higher than the indicator of effectiveness in the control group – 52.0%. Thus, the hypothesis of exceeding the effectiveness of treatment in the study group of patients as compared with the control was confirmed.
«Bulletin of problems biology and medicine» Issue 2 (144), 2018 year, 173-176 pages, index UDK 616.381-002.1-036-085:615.279
