Abstrakt: |
The subjects of the study were 82 patients with penetrating gunshot (17 cases) and stab-and-cut (65 cases) thoracal and abdominal wounds, complicated by an acute blood loss of 600 to 4500 ml. Aerobic metabolism of neutrophiles was studied using spontaneous and activated HCT test and chemoluminescent analysis; the concentration of acute phase proteins (fibronectin, ceruloplasmin, C-reactive protein, and haptoglobin) during the first two days after surgery was measured. The study revealed that bigger blood loss was associated with more pronounced increase of the number of spontaneously activated neutrophiles with low bactericidal potential, decrease of fibronectin and ceruloplasmin concentrations, and increase of C-reactive protein and haptoglobin concentrations. Retrospective analysis of the treatment results showed that the rate of suppurative complications did not depend on the wound character or blood loss volume, but was higher in patients with prolonged disbalance of acute phase proteins and aerobic metabolism (12.4% vs. 2.6% in patients without such disturbances). |