Peculiarities of course of operational and postoperative periods in appendectomy after various methods of the antibiotics introduction

I. Duzhyi, V. Shimko, G. І. Pyatikop, O. Sytnik, V. Pak
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Abstract

Objective. To study the peculiarities of antibiotics accumulation in appendix vermiformis after various methods of their introduction. Materials and methods. The investigation was conducted in 160 patients, to whom antibiotic was introduced by various methods: 53 – intramuscularly; 52 – intravenously; 55 – lymphotropically. In part of the patients the antibiotic was introduced at 1 h preoperatively, and to the rest – at 2 h. After performance of appendectomy from each third part of the appendix vermiformis (proximal, middle and distal) excised a homogenate was made, which was sowed into Petri dish on the laboratory culture of E. coli. In a day there were stunting growth zones registered in this laboratory culture in millimeters, and in accordance to their dimensions the level of the antibiotic accumulation was determined. Results. After intramuscular introduction the antibacterial preparation in tissues of appendix vermiformis did not accumulate. After intravenous introduction of ceftriaxone at 1 h preoperatively it have accumulated in 65.4% patients in proximal and middle thirds of appendix vermiformis, in 34.6% patients in the appendix vermiformis apex the antibiotic accumulation was not observed. After the antibiotic introduction 2 h preoperatively its concentration have diminished in two times. After lymphotropic introduction the antibiotic have accumulated in all parts of appendix vermiformis, and in 2 h its quantity have enhanced significantly. Conclusion. Accumulation of antibiotic in the appendix vermiformis after it intravenous introduction have rapidly reduced, and after a lymphotropic one – enhanced, witnessing the advantage of lymphotropic method, which must become the alternative one in appendicitis, due to its targeticity and property for accumulation.
不同方法应用抗生素后阑尾切除术手术过程及术后时期的特点
目标。目的:研究不同方法引入抗生素在蚓尾虫体内积累的特点。材料和方法。对160例患者进行了调查,通过各种方法给药:53例肌内给药;52 -静脉注射;淋巴性。部分患者术前1小时使用抗生素,其余患者术前2小时使用抗生素。阑尾切除术后,从切除的每三分之一阑尾(近端、中端和远端)制作匀浆,将其播种到实验室培养大肠杆菌的培养皿中。在一天内,在这个实验室培养物中以毫米为单位记录了发育不良的生长区域,并根据其尺寸确定了抗生素积累的水平。结果。经肌肉注射后,抗菌制剂在蚓尾组织内无蓄积。术前1 h静脉滴注头孢曲松后,65.4%的患者在蚓尾近端和中三分之一处有抗生素积累,34.6%的患者在蚓尾尖端未见抗生素积累。术前引入抗生素2小时后,其浓度下降了两倍。嗜淋巴性引入后,抗生素在蚓尾各部位积累,并在2h内数量显著增加。结论。静脉引入抗生素后,蚓状阑尾的蓄积迅速减少,而嗜淋巴法蓄积增强,可见嗜淋巴法的优势,由于其靶向性和蓄积性,必须成为阑尾炎治疗的替代方法。
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