THE CHARACTERISTICS OF CYTOKINE STATUS IN PATIENTS WITH DEEP PHLEGMON OF THE NECK AND SECONDARY ACUTE MEDIASTINITIS UNDER DIFFERENT METHODS OF TREATMENT

Author: Pustovetova M.G.¹, Chikinev Yu.V.², Drobyazgin Ye.A³, Kutepova T.S.⁴

Abstract

The aim of the study was to improve the results of treatment of patients with deep neck phlegmon and acute secondary mediastinitis. Material and methods. 81 case histories of patients with deep neck phlegmon and 40 case histories of patients with secondary acute mediastinitis who underwent examination and treatment in the regional clinical hospital, Novosibirsk, for the period from 2007 to 2017 were analyzed. The results of treatment were evaluated by the dynamics of changes in the serum concentration of pro- and anti-inflammatory cytokines TNF-α, IL-1ß, IL-6, IL-8, IL-4, IL-1β/IL-4. Results and discussion. When applying the method of lavage of deep neck and mediastinum cellular spaces with ozonated 0,9 % sodium chloride solution, there is a 1,2-3-fold faster normalization of cytokine status compared to standard lavage, which indicates a more pronounced decrease in the intensity of the acute inflammatory process in the postoperative period.

Key words

deep neck phlegmon, mediastinitis, lavage with ozonated solution, pro- and anti-inflammatory cytokines

References

Ashinaliev A.A., Stepanchuk I.V., Bejshenaliev A.S. Surgical treatment of acute mediastinitis. Vestnik Kyrgyzskoy gosudarstvennoy meditsinskoy akademii imeni Isy Konoyevicha Akhunbayeva = Bulletin of the Kyrgyz State Medical Academy named after Isa Konoevich Akhunbaye. 2016; (2): 95-97. [In Russian].

Danielyan Sh.N., Abakumov M.M., Pogodina A.N., Sharifullin F.A., Barmina T.G., Kvardakova O.V., Chernen'kaja T.V. Diagnosis and surgical treatment of posttraumatic purulent mediastinitis. Khirurgia = Surgery. 2011; (12): 47-54. [In Russian].

Dobrokvashin S.V., Sysoev P.N., Dem'janov S.L. Surgical treatment of patients with acute mediastinitis. Vestnik sovremennoy klinicheskoy meditsiny = Bulletin of contemporary clinical medicine. 2014; (7): 64- 67. [In Russian].

Freeman R.K., Vallieres E., Verrier E.D. Descending necrotizing mediastinitis: an analysis of the effects of serial surgical debridement on patient mortality. J. Thorac. Cardiovasc. Surg. 2000; 119: 260-266.

Gib M.C., Alvarez J.S., Wender O.C. Mediastinitis: mortality rate comparing single-stage surgical approach and preconditioning of wound. Rev. Bras. Cir. Cardiovasc. 2013; 28 (2): 200-207.

Katanov E.S., Matveev V.Ju., Stoljarov S.I., Krasnov G.N. i dr. Experience of treatment of patients with acute odontogenic purulent mediastinitis. Prakticheskaya meditsina = Practical medicine. 2016; 4 (1): 102-106. [In Russian].

Kocher G.J., Hoksch B., Caversaccio M., Wiegand J., Schmid R.A. Diffuse descending necrotizing mediastinitis: surgical therapy and outcome in a single-centre series. Eur. J. Cardiothorac. Surg. 2012; 42 (4): 66-72.

Liao Y.S., Lai C.C., Tan C.K., Lin S.H. Deep neck infection with descending necrotizing mediastinitis presenting with out-of-hospital cardiac arrest. QJM. 2013; 106 (7): 663-665.

Lishov E.V., Haritonov A.A., Putincev A.M. Features of surgical treatment of anaerobic infections of deep neck spaces complicated by mediastinitis. Acta Biomed. Sci. 2017; 2 (6): 130-133. [In Russian].

Mihos P., Potaris K., Gakidis I., Papadakis D., Rallis G. Management of descending necrotizing mediastinitis. J. Oral Maxillofac. Surg. 2004; (8): 966-972.

Puzanov D.P. Slavinskij V.G. Surgical treatment of upper mediastinitis. Mezhdunarodnyy zhurnal prikladnykh i fundamental'nykh issledovaniy = International journal of applied and basic research. 2015; (8-4): 686-688. [In Russian].

Shevchuk I.M., Snezhko S.S. Causes and ways of distribution of phlegmons of the neck, complicated by descending suppurative mediastinitis. Khirurgiya. Vostochnaya Yevropa = Surgery. Eastern Europe. 2014; (4): 9-15. [In Russian].

Shonbin A.N., Bystrov D.O., Zavolzhin A.S., Elizarov M.V., Jarkovoj M.A. Mediastinitis after cardiac surgery. Annaly khirurgii = Annals of surgery. 2012; (4): 56-60. [In Russian].

Stolyarov S.I., Danilov V.V. Preventive mediastinotomy in descending odontogenic mediastinitis. Zdorov'ye. Meditsinskaya ekologiya. Nauka = Health. Medical ecology. Science. 2017; 69 (2): 74-76. [In Russian].

Svistushkin V.M., Mustafaev D.M. Purulent-inflammatory diseases of the neck: a modern view on the management of patients. Meditsinskiy sovet = Medical Council. 2016; (18): 58-63. [In Russian].

Yuldashev I.M., Urgunaliev B.K., Ashinaliev A.A., Moldaliev E.K., Yuldasheva D.T., Kasenova N.S. Total odontogenic mediastinitis as a complication of the putrefactive-necrotic phlegmon of the bottom of the oral cavity. Tikhookeanskiy meditsinskiy zhurnal = Pacific Medical Journal. 2011; (3): 97–98. [In Russian].

About Authors (Correspondence):

Kutepova T.S., e-mail: tgemini1388@mail.ru

Full Text

snmzh_4-2019_pustovetova_137-142.pdf

Received: 02/09/2019

Accepted: 02/09/2019