Endogenous intoxication at surgical infection. Methods of detoxication and immunocorrection

Endogenous intoxication (EI) at purulent inflammation is a syndrome, conditioned resorption of bacterial toxins, products of disintegration of tissues at purulent inflammation, rendering a toxic action.

Toxicosis accompanies all of types of purulent inflammation, in basis of him is резорбция from the festering hearth of products of purulent-putrid disintegration of tissues. Resorption takes a place lympho- and hematogenous by a way.

Between the degree of expressed of endogenous toxicosis at purulent inflammation and weight of suppurative process there is close and direct dependence – with liquidation of purulent hearth, if irreversible changes did not happen in an organism, the general phenomena of toxicosis are liquidated. The last allows to distinguish endogenous toxicosis from a sepsis.

It is possible to select a few groups of markers of endogenous intoxication:

1. Biochemical

2. Immunological

3. Integral

Polypeptide of middle molecular mass (middle molecules – MM) consider the generally accepted markers of endogenous intoxication – matter weight from 500 to 5000 dalton. The feature of toxic action of MM is that, that they possess a direct membrane-toxic action.

Laboratory markers of EI

• making progress anaemia;

• leukocytosis and change of leukocyte formula to the left;

• acceleration of blood sedimentation test;

• increase of indexes of intoxication (leucocytal index of intoxication, level of middle molecules);

• lymphocyte depletion;

• T- lymphocyte depletion;

• thrombocyte depletion;

• determination of level of цитокинов, the increase of which testifies to progress of pathology.

The immunological markers of EI are included by indexes, which represent quantitative correlation of immunocytes, its functional activity, adequacy of regulator mechanisms of immune answer and specific components of activity of immunocytes. Quantitative maintenance of leuko-, lympho-, thrombocytes – basic elements of cellular immune answer.

CLINIC.

State of consciousness: languor, somnolence, amnesia, delirium, stupor, coma.

State of intellect:

The I stage is the hidden changes, the interval of attention is brief;

The II stage is a loss of feeling of time, retrograde amnesia, violation of account;

The III stage is disorientation;

The IV stage is a loss of perception of the world and absence of intellect.

State of conduct:

The I stage is euphoria or depression, irritate;

The II stage is a change a feature, anxiety, apathy, improper behaviour;

The III stage - a conduct, paranoia, anger, ferocity, is entangled;

The IV stage is absence of conduct.

Нервно-мышечные disorders:

The I stage is metabolic trepidation, absence of muscular co-ordination, violation of letter;

The II stage is the scanned language, decline of reflexes, ataxia;

The III stage is an increase of reflexes, nystagmus, reflex of Babinsky, clonus, rigidity;

The IV stage is expansion of pupils, opisthotone, coma.

Modern efferent medicine owns a few ten of efferent methods which de bene esse can be united in a few groups: