MORPHOLOGICAL SUBSTANTIATION OF THE EFFECTIVENESS OF PHOTODYNAMIC THERAPY IN CASE OF WIDESPREAD PERITONITIS IN AN EXPERIMENT

Аннотация

INTRODUCTION [8]. It should be noted that the question of the Despite the achievements of modern medical choice of the sanitizing solution remains one of the science, the issues of prevention, diagnosis and most controversial, the discussion about the treatment of peritonitis remain relevant. Mortality methods of intraoperative sanitation of the in acute peritonitis varies from 32.4-45.5% to 50- abdominal cavity continues to this day [6,7], and 90% [2,7,9]. Various microorganisms play an according to Gostishchev G, it is advisable to use essential role in the etiology of peritonitis. In the those solutions that can be administered vast majority of cases, peritonitis is the result of parenterally [5]. In recent years, the method of autoinfection, which is usually polymicrobial in photodynamic therapy has been introduced into nature [3,8,10]. It is known that the successful surgical practice in connection with the result of treatment of diffuse purulent peritonitis bactericidal properties of photosensitizers depends only 15-20% on the effectiveness of associated with the formation of singlet oxygen antibacterial therapy, and the remaining 80% are against the background of photochemical associated with adequate surgical tactics, reactions. There are publications on the use of including full sanitation of the abdominal cavity photodithiazine, chlorophyllipt, dimegin, etc. as https://www.theamericanjournals.com/index.php/tajmspr 27 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE10 photosensitizers. The problem of the choice of a their introduction into ether anesthesia. As a light photosensitizer for PDT [10], as well as the study source for the PDT session, a domestic-made LED of their effect on the ultrastructural elements of the installation "FDU-1" with an output power of 100 peritoneum in peritonitis [4,7], remains urgent. mW / cm2, a wavelength of 630 ± 20 nm in a However, studies on the effect of methylene blue continuous red optical range was used. The energy (MS) on the ultrastructure of the healthy density during the LED irradiation session was 25- peritoneum, and in experimental peritonitis on the 35 J / cm2, the exposure time was 3-5 minutes. In inflamed peritoneum, we have not seen. In this the control group, the abdominal cavity was regard, the purpose of our study was: to study the sanitized by a similar method as in the main group, effect on the ultrastructural elements of the then 0.02% chlorhexidine solution was poured visceral and parietal peritoneum of methylene into the abdominal cavity, draining. The blue, 0.02% chlorhexidine, LED radiation and laparotomic wound was sutured through all layers photodynamic therapy in normal conditions and in with silk, the animals were marked and placed in experimental peritonitis. standard vivarium conditions. To study the ultrastructural elements of the visceral and METHODS parietal peritoneum, the intestine with the visceral The experiments were divided into 3 stages: 1) to peritoneum in rats was taken in the area of the study the histological structure of the visceral and ileocecal junction (with the visceral peritoneum), parietal peritoneum in healthy experimental the parietal peritoneum in the lateral surface of the animals; 2) to study the effects of methylene blue, abdomen. Pieces of 0.5 1.0 cm in size of the small chlorhexidine and LED radiation on the intact and large intestines of all experimental animals peritoneum separately; 3) to study the effect of were fixed in 10-12% neutral formalin with a 0.02% chlorhexidine solution and photodynamic volume of 0.5 cm3, then washed in running water, therapy, i.e., LED radiation and methylene blue at a dehydrated in alcohols of increasing concentration of 0.05% per peritoneum in concentration, impregnated with xelol and experimental peritonitis in a comparative aspect. embedded in paraffin. Sections were stained with To create a model of acute experimental hematoxylin and eosin using a conventional widespread purulent peritonitis, we used the method, fixed with Canadian balsam, and then technique of Yu.Yu. Blinkov, (RF Patent No. covered with glass. When viewing and describing 2338265) [1]. In the group of animals with the micro preparations, an electronic binocular experimental peritonitis during the operation, the microscope CYAN was used. Model DN-30OM. abdominal cavity was drained with suction, then With 34 MP MICROSCOPE Camera attachment, washed with saline. 3 ml of 0.05% methylene blue ocular objective magnification from x = 4x10x0.5, x solution was poured into the abdominal cavity = 10x0.25x0.5, x = 40x0.65x0.5. with a syringe and left for 5 minutes, then the RESULT AND DISCUSSION solution was removed by suction and PDT was started. The laparotomic wound was sutured At the first stage of our research, we studied the through all layers with silk, the animals were ultrastructural structure of the parietal and marked and placed in