Русский
Prevention of perioperative complications in children with congenital uropathies
DOI: https://dx.doi.org/10.18565/urology.2019.4.85-90
O.L. Morozova, D.A. Morozov, D.Y. Lakomova, L.D. Maltseva, D.D. Morozov
1) Sechenov First Moscow State Medical University, Moscow, Russia; 2) Saratov State Medical University n. a. V.I. Razumovsky, Saratov, Russia
Aim. To substantiate the expediency of immunomodulators and probiotics application pathogenetically in the comprehensive preoperative preparation in children with congenital
uropathies (СU).
Materials and methods. The study includes 60 patients with various types of congenital uropathy (CU) (vesicoureteral reflux, hydronephrosis, obstructive ureterohydronephrosis), which were divided into 3 groups in accordance with the preoperative preparation complex. 1 group – 20 patients with VU, immunomodulating drug Kipferon was added to the therapy at the preoperative stage, group 2 – 20 patients with VU – with the addition of the biologically active additive (BAA) «Bifidum №791 BAG», 3 control group – 20 children with VU standard complex of preoperative preparation. The diagnosis of VU was established using a standard urological examination. The examination of the content of pro-(IL-8) and anti-inflammatory (IL-10) cytokines in the urine was performed before the start of treatment (1 point) and on the 3-5th day after surgery (2 point) for all patients using the method of enzyme-linked immunosorbent assay.
Results. Based on signs of systemic inflammation and urinary syndrome, initially patients of all groups (n=60) were in the latent phase of chronic obstructive pyelonephritis. After surgical correction pyelonephritis was diagnosed in all children at point 2, the most pronounced was in the control group. Manifestation of dysbiosis in the control group was more often by 20% than in group 2. The examination of the cytokine profile of urine showed an increasing the level of IL-8 (p<0.0001) at 2 points in all groups, the most significant was in the control group (p<0.002). An increasing the level of IL-10 (p<0.0001) was noted at point 2 in all groups, the most significant was in groups 1 and 2 (p<0.003). High values of the inflammation activity index were observed only at point 2 in the children of the control group (p<0.001).
Conclusion. The using of immunomodulators and probiotics in the comprehensive preoperative preparation of children with obstructive uropathies reduces the risk, severity and duration of postoperative complications.
uropathies (СU).
Materials and methods. The study includes 60 patients with various types of congenital uropathy (CU) (vesicoureteral reflux, hydronephrosis, obstructive ureterohydronephrosis), which were divided into 3 groups in accordance with the preoperative preparation complex. 1 group – 20 patients with VU, immunomodulating drug Kipferon was added to the therapy at the preoperative stage, group 2 – 20 patients with VU – with the addition of the biologically active additive (BAA) «Bifidum №791 BAG», 3 control group – 20 children with VU standard complex of preoperative preparation. The diagnosis of VU was established using a standard urological examination. The examination of the content of pro-(IL-8) and anti-inflammatory (IL-10) cytokines in the urine was performed before the start of treatment (1 point) and on the 3-5th day after surgery (2 point) for all patients using the method of enzyme-linked immunosorbent assay.
Results. Based on signs of systemic inflammation and urinary syndrome, initially patients of all groups (n=60) were in the latent phase of chronic obstructive pyelonephritis. After surgical correction pyelonephritis was diagnosed in all children at point 2, the most pronounced was in the control group. Manifestation of dysbiosis in the control group was more often by 20% than in group 2. The examination of the cytokine profile of urine showed an increasing the level of IL-8 (p<0.0001) at 2 points in all groups, the most significant was in the control group (p<0.002). An increasing the level of IL-10 (p<0.0001) was noted at point 2 in all groups, the most significant was in groups 1 and 2 (p<0.003). High values of the inflammation activity index were observed only at point 2 in the children of the control group (p<0.001).
Conclusion. The using of immunomodulators and probiotics in the comprehensive preoperative preparation of children with obstructive uropathies reduces the risk, severity and duration of postoperative complications.
Keywords: Kipferon, congenital uropathy, dietary supplement, chronic obstructive pyelonephritis, children, cytokines
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