Therapy correction in conditions of leukocyte and erythrocyte disturbed homeostasis in secondary widespread peritonitis in children of different ages

The disturbance depth of leukocyte and erythrocyte homeostasis is of no small importance in determining the severity of secondary widespread peritonitis in different age groups of children. Materials and methods. A  retrospective  clinical  study  of  85  patients  of  different  ages  with  secondary  widespread  peritonitis  was conducted. Determination of structural changes in leukocytes, neutrophils and erythrocytes was carried out before surgery and 1, 5 and 7 days after surgery. Objective. Development of methods for correcting therapy based on the assessment of leukocytes, neutrophils and erythrocytes structural changes in secondary widespread peritonitis in children of different ages. Research results. The conducted studies have demonstrated significant age  differences  in  the  structural  transformations  of  leukocytes,  neutrophils  and  erythrocytes  in  secondary widespread peritonitis. In younger patients, there was a greater growth in the content of white blood cells and a slower dynamics of their decrease throughout the postoperative period. A comparatively greater decrease in the width of the distribution and the average volume of erythrocytes in younger children indicated a smaller difference between micro- and macrocytes with the erythrocyte microcytosis dominance. The inclusion of a carbapenem group drug (Invanz) in the antibacterial therapy regimen and the prescription of an antihypoxant (Mexidol)  improved  the  treatment  results  for  children  with  secondary  widespread  peritonitis.  Сonclusion. Persistent enlargement in the number of leukocytes and neutrophils in younger age groups patients indicates a comparatively severe course of the infectious process in the abdominal cavity, which causes a more frequent development of postoperative purulent inflammatory complications. A material shift in the erythrocyte pool towards microcytosis at a younger age significantly reduces the functionality of red blood cells and leads to the occurrence of intra-abdominal «hypoxic stress». Correction of the antibacterial therapy regimen with the invanz inclusion and the mexidol administration creates the preconditions for a favorable course of the early postoperative period in children of different ages.

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