New approaches to the treatment of acute peritonitis

Abstract

The high prevalence of acute peritonitis, its unpredictable course, and the rapid development of systemic dysfunctions necessitate further study of the disease. It is relevant to use the principle of personalized medicine, which is based on the selection of diagnostic, therapeutic and preventive means taking into account the patient's genetic, physiological, biochemical and other characteristics. The paper presents data on the diagnosis and treatment of acute peritonitis in 246 patients who, in addition to standard clinical, biochemical, immunoenzymatic and genetic studies, were conducted to determine the role of proinflammatory cytokines (IL1β) in the pathogenesis of the inflammatory process and the development of its complications. The dependence of the manifestations of inflammation and it’s spread on the concentration of IL1β in the blood and variants of the IL1β gene (‒511C/T), which regulates its secretion, is shown. The processes of peroxidic oxidation, antioxidant protection, unlimited proteolysis, fibrinolytic activity in the implementation of systemic reactions in peritonitis were studied, and their individual variability was shown. On the basis of the conducted research, the stages of surgical interventions, drug treatment schemes and proposed methods of prevention of various complications have been improved. This approach to diagnosis, forecasting the course of acute peritonitis, and the choice of treatment tactics is personalized and provides an opportunity to significantly improve the results of treatment of such patients and reduce mortality.

Keywords: peritonitis, genetic studies, systemic inflammatory reactions, prognosis.