• Prediction of the postoperative period in women with simultaneous surgery

Prediction of the postoperative period in women with simultaneous surgery

HEALTH OF WOMAN. 2018.10(136):88–90; doi 10.15574/HW.2018.136.88

Dronova V. L. , Dronov О. I. , Mokryk О. М. , Teslyuk R. S. , Bakunets Y. P. , Bakunets P. P. , Roshina L. O.
SI «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanovaya NAMS of Ukraine», Kyiv
Bogomolets National Medical University, Kiev
Kyiv City Clinical Hospital No. 10

The article presents data on the prediction of the postoperative period in women with simultaneous surgery.

The objective: to predict the course of the postoperative period in women with simultaneous surgery, namely uterine leiomyoma and lower limb varicose vest on the basis of an assessment of the immunological and psychological status, which will improve the quality of life and reduce the postoperative rehabilitation period.

Materials and methods. In order to solve the tasks, in the Department of Operative Gynаecology, 27 women were examined with combined gynaecological and extragenital surgical pathology, who, along with general clinical examinations, conducted an immunological study and psychological status assessment. In order to predict the postoperative period in patients after performing simultaneous surgery (uterine leiomyoma and lower limb varicose veins), we used indicators of the immunological status, namely interleukin-6 (IL-6), C-reactive protein (CRP). Blood sampling for the study was carried out before the operation, on days I, II, and III of the postoperative period and the indicators for assessing the psychological status on the Spielberger – Hanin scale of anxiety and Beck’s depression scale. The data for this study were obtained during 2017 in the SI «IPOG nam.acad. E.M.Lukyanova NAMS Ukraine».

Results. The most informative indicator of the severity of surgical aggression is interleukin-6. It reflects proportionally the degree and dynamics of surgical trauma. An increase in the concentration of CRP in the postoperative period was delayed for a day after the increase in the concentration of IL-6 in the study group. This can be explained by the fact that the delayed response to CRP is a consequence of the activation and stimulation of its synthesis of IL-6, which is confirmed by the data of scientific literature. C-reactive protein indirectly responds to injury and can be used as an additional study when monitoring in the postoperative period. A rapid and reliable decrease in the concentration of interleukin-6, starting from the II day of the postoperative period, most objectively reflects the course of reparative processes, correlating with the terms of rehabilitation of patients.

Conclusion. The results of the study show that the performance of simultaneous operations contributes to a positive induction of the immune response under conditions of substantial inhibition of immunoreactivity. At the same time, the rehabilitation of patients in the postoperative period is faster. Thus, a method for predicting the postoperative period in women with simultaneous surgical interventions can be used in gynecological and surgical departments where patients are given simultaneous surgical care.

Key words: simultaneous operations, interleukin-6, C-reactive protein, psychological status.

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