METHOD FOR DIFFERENTIATED APPLICATION OF HYPERBARIC OXYGENATION (HBO) FOR PATIENTS WITH TUMOURS OF REPRODUCTIVE SYSTEM AFTER LIVER TRANSPLANTATION

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, transplantology, physiotherapy, gynaecology and oncology, anaesthesiology and resuscitation. In the early postoperative period, the first session of hyperbolic oxygenation (HBO) is performed for 60 minutes. During first 20 minutes, HBO is performed in a continuous pressure increase mode in an altitude test chamber from 1.0 ATM to a maximum value selected from interval of 1.4–1.6 ATM, with a heart rate of not more than 100 beats per minute and blood pressure more than 130 mm Hg. Subsequent 20 minutes of HBO are performed at the maximum value of ATM selected for the patient. Remaining 20 minutes of HBO are performed at continuous pressure reduction from maximum value to initial value of 1.0 ATM. At the same time immediately before the first session of HBO and after its end, blood is sampled into a test tube with an anticoagulant based on heparin and measuring for 15 min using a potential potentiostat with an open circuit (POC) of a platinum electrode relative to a silver-silver electrode placed in blood plasma. After the first session, the POC value, which is in the range of values from -20.9 mV to +17.9 mV, is obtained, for patients with the transplanted liver, the efficacy of HBO is stated and treatment is continued by repetition of sessions every other day with preservation of the mode corresponding to the first session, with number of sessions from six to seven. When plasma POC value of plasma electrode of platinum going beyond said range of values is compared, comparison is carried out with value of POC measured prior to beginning of HBO session, and estimating shear |ΔPOC|. If after the first session of HBO displacement occurred towards specified range of values and |ΔPOC|≥10 mV, the second HBO session is performed with increasing the time of staying at the maximum pressure value for 5–10 minutes, and measurement of POC of platinum electrode before and after the second session. In case plasma value of platinum electrode in blood plasma is displaced after second HBO session to area of said values interval, treatment is continued with preservation of the selected mode of the second session by repetition of sessions every other day, with total number of sessions from six to seven. When the value of POC is obtained after the second HBO session outside the specified range of values, the absence of HBO efficiency is stated and the treatment is stopped.;EFFECT: method enables the possibility of differential selection of therapy with application of hyperbaric oxygenation in patients with tumours of the reproductive system after liver transplantation.;1 cl, 1 dwg, 1 ex