4 research outputs found
Effect of ethanolamine oleate and polidocanol on the respiratory function and blood count in patients treated with esophageal variceal sclerotherapy
Wst臋p: Celem pracy by艂o przeprowadzenie analizy wymiany gazowej w p艂ucach po skleroterapii
偶ylak贸w prze艂yku z zastosowaniem roztworu 5% etanolaminy (EO) i 3% polidokanolu (PK)
oraz ustalenie wp艂ywu enoksaparyny (Enox) na zmiany gazometryczne w p艂ucach i morfologi臋
krwi oraz obraz radiologiczny p艂uc u chorych po skleroterapii (ST) z zastosowaniem 5% EO.
Ponadto celem pracy by艂a ocena zmian w badaniu morfologicznym krwi i obrazie radiologicznym
p艂uc po ST lub podwi膮zaniu 偶ylak贸w prze艂yku (P呕P) oraz okre艣lenie rodzaju i cz臋sto艣ci
powik艂a艅 po zabiegach.
Materia艂 i metody: Badania przeprowadzono w 4 grupach, o liczebno艣ci 30 chorych w ka偶dej
grupie: grupa I (EO) — ST z 5% EO, grupa II (PK) — ST z 3% PK, grupa III (EO + Enox)
— przed zabiegiem ST z 5% EO wstrzykiwano podsk贸rnie enoksaparyn臋, grupa IV (P呕P) —
P呕P. Wykonano badania gazometryczne krwi t臋tniczej i 偶ylnej przed oraz w 1., 5., 15., 30., 60.
i 120. minucie po zabiegu: pO2, pCO2, pH, satO2. Przed zabiegiem, w 90 minut i 24 godziny po
oznaczano: hematokryt (Ht), hemoglobin臋 (Hb), liczb臋 krwinek czerwonych (RBC), bia艂ych
(WBC) i p艂ytek krwi (Plt). Badania radiologiczne p艂uc wykonywano przed i 48 go-dzin po
zabiegu.
Wyniki: Wyniki bada艅 gazometrycznych krwi t臋tniczej: paO2 — w grupie I i II stwierdzono
znamienny spadek, a w III i IV warto艣ci nie wykazywa艂y istotnych zmian; paCO2 — w grupie I
w III obni偶y艂o si臋 i wzros艂o, w II wzros艂o, a w IV obserwowano obni偶enie; pHa — w grupie I
i w III stwierdzono wzrost, w II wzrost i spadek, a w IV nie stwierdzono zmian; sataO2 —
w grupie I i II obni偶enie, w III i IV warto艣ci nie wykazywa艂y istotnych zmian.
Wyniki bada艅 gazometrycznych krwi 偶ylnej: pvO2 — w grupie I i II warto艣ci nie wykazywa艂y
istotnych zmian, w III i IV nast膮pi艂 wzrost; pvCO2 — w grupie I stwierdzono wzrost, w II i IV
spadek, w grupie III spadek i wzrost; pHv — w grupie I, II i III stwierdzono wzrost, a w IV
warto艣ci nie wykazywa艂y istotnych zmian; satvO2 — w grupie I spadek, w II, III i IV wzrost.
Sk艂adniki morfologiczne: warto艣ci Ht, Hb, RBC, WBC, Plt obni偶y艂y si臋 znamiennie w 90.
minucie po zabiegu we wszystkich grupach. Po 24 godzinach zmiany cech morfologii nie wykazywa艂y statystycznie istotnych r贸偶nic w por贸wnaniu z warto艣ciami wyj艣ciowymi. Zmiany
radiologiczne p艂uc: odczyn op艂ucnowy stwierdzono u 4 chorych w grupie I, u 6 w II, u 3 w III
i u 3 w IV. Zmiany zapalne stwierdzono u 2 chorych w grupie I, u 2 w II, u jednego w III i w IV.
Wnioski:
1. Zabiegi ST 偶ylak贸w prze艂yku z zastosowaniem 5% EO i 3% PK wywo艂uj膮 zaburzenia
gazometryczne we krwi t臋tniczej i 偶ylnej, objawiaj膮ce si臋 obni偶eniem pO2 i satO2 oraz
zwi臋kszeniem pCO2 i pH.
2. Zaburzenia wymiany gazowej w p艂ucach s膮 przej艣ciowe i nie wywo艂uj膮 偶adnych objaw贸w
klinicznych u leczonych chorych.
3. Wstrzykni臋cie enoksaparyny przed zabiegiem ST, z u偶yciem 5% EO, zapobiega rozwojowi
obserwowanych zmian w gazometrii.
4. Warto艣ci sk艂adnik贸w morfologicznych krwi obni偶y艂y si臋 w 90. minucie po zabiegu ST i P呕P
i nie powodowa艂y zmian w stanie klinicznym u chorych.
5. Zabiegi ST z u偶yciem 5% EO i 3% PK wywo艂uj膮 zmiany radiologiczne w p艂ucach, objawiaj膮ce
si臋 wysi臋kowym zapaleniem op艂ucnej i zmianami niedodmowo-zapalnymi.
6. Obserwowane po zabiegach ST objawy, takie jak b贸le zamostkowe, stany podgor膮czkowe,
przej艣ciowa gor膮czka i nudno艣ci zalicza si臋 raczej do objaw贸w towarzysz膮cych ST ni偶 do
rzeczywistych powik艂a艅.
J. Transf. Med. 2011; 2: 82–98Background: The aim of the study was to perform the analysis of gasometric exchange in
lungs following esophageal variceal sclerotherapy with 5% EO and 3% PC, determine the effect
of enoxaparin on the gasometric changes in the lungs, on blood count as well as on the
radiological image of the lungs in patients treated with 5% EO, evaluate the changes in the
blood count and the radiological image of the lungs after ST and EVL and determine the type
and frequency of complications following sclerotherapy procedure.
Material and methods: The study was conducted in four groups of 30 patients each: group I
(EO) — ST with 5% EO, group II (PC) — ST with 3% PC, group III (EO + Enox) —
endoxaparin was injected subcutaneously prior to ST with 5% EO and group IV (EVL) —
EVL. Gasometric investigations of arterial and venous blood (pO2, pCO2 pH, satO2 ) were
performed prior to each procedure as well as 1, 5, 15, 30, 60 and 120 min after. The following
parameters were determined prior to procedure, in the 90 min and 24 hours after procedure;
Ht, Hb, RBC, WBC, platelet count. Radiological examinations of the chest were performed
prior to and 48 hours after procedure.
Results: Results for arterial blood: paO2, decrease was statistically significant in group I and
II but the changes in group III and IV were not; paCO2 decreased to increase in groups I and
III, increased in group II and decreased in group IV; pHa — increased in groups I and III,
increased to decrease in goup II and no changes were observed in group IV; sataO2 decreased
in groups I and II, and no significant changes were observed in groups III and IV.
Results for venous blood: pvO2, values showed no significant changes in groups I and II but an
increase was observed in groups III and IV; pvCO2 increased in group I, decreased in group II
and IV and decreased to increase in group III; pHv — values increased in group I , II and III
and no changes were observed in group IV; satvO2 — decreased in groups I and increased in
groups II, III and IV.
Blood parameters (Ht, Hb, RBC, WBC, platelet count) significantly decreased in 90. min following
procedure in all four groups. After 24 h no statistically significant changes in blood parameters
were observed as compared to initial values. Radiological changes in the lungs — pleural reactions
were observed in 4 patients from group I, in 6 from II, in 3 from III and 3 from IV. Inflammatory
reactions were reported in 2 patients from group I, in 2 from II, in one from III and IV.
Conclusions:
1. Esophageal variceal sclerotherapy with 5% EO and 3% PC causes gasometric changes in
arterial and venous blood manifested as decrease of pO2 and SatO2 as well as increase of
pCO2 and pH.
2. Disturbances of gasometric exchange in lungs are transient and cause no clinical symptoms.
3. Injections of enoxaparin prior to ST with 5% EO prevent such changes in gasometric
parameters.
4. Blood count increased in 90 minutes after ST and EVL with no changes in clinical
state of patients.
5. ST with 5% EO and 3% PC is the cause of radiological changes in the lungs manifested as
exudative pleuritis and atelectatic changes.
6. Symptoms observed after ST such as retrosternal pain, subfebrile body temperature, transient
fever and nausea, are regarded rather as ST-associated symptoms than real complications.
J. Transf. Med. 2011; 2: 82–9
Effectiveness of laser therapy in the elimination of prosthetic stomatitis symptoms in a group of female patients with osteoporosis and unfavourable prosthetic foundation conditions
Introduction. Irreversible changes in bone mass and structure of the masticatory system occurring in patients with osteoporosis affect the results of prosthetic treatment and many patients suffer due to stomatopathy symptoms. Laser therapy has an anti-inflammatory, analgetic, and anti-edematous effect. Aim of the study. The aim of the study is to evaluate the effectiveness of laser therapy in the elimination of prosthetic stomatitis symptoms in a group of female patients with osteoporosis and unfavourable prosthetic foundation conditions. Material and methods. The study concerned two groups of patients (20 women); one with osteoporosis or osteopenia and the other healthy group with an unfavourable state of prosthetic foundation. Prosthetic treatments were performed. Patients were asked to assess the presence of pain. A clinical assessment of the state of the prosthetic foundation was performed. As an additional comprehensive treatment biostymulation laser therapy was performed using a Doris CLT-1106 laser. Results. The study revealed a reduction of pain and prosthetic stomatitis symptoms in both groups. A regeneration of tissues in the prosthetic foundation was observed. The questionnaire study confirmed the positive effects of laser therapy. The functional aspects of prosthetic appliances in patients with osteoporosis were rated as satisfactor