DI Malik, EA Boyko, Regional Clinical Hospital, Kemerovo
According to foreign authors, malnutrition significantly impairs the postoperative period and causes an increased risk of complications. SR Jamieson et al. (1997) reported that optimization of the supply of surgical patients leads to an improvement in functional status and quality of life. Important role in the mechanisms of general adaptation to surgical trauma are the processes of oxidative metabolism, largely depend on the income of antioxidants (AO) with food.
Studied the antioxidant status of plasma 122 geriatric patients undergoing surgery for benign prostatic hyperplasia (51%), kidney cancer (14%), bladder (27%), prostate (4%), other diseases of the genitourinary system (4%). The plasma parameters were determined by enzymatic and non-enzymatic antioxidant defense units: activity of superoxide dismutase (SOD) and catalase, the concentration of alpha-tocopherol, and the concentration of lipid peroxidation products - TBA-reactive products (TBA-RP). Blood sampling was performed immediately before surgery, on the first, fifth and tenth day after surgery in the morning on an empty stomach.
Patients of the control group (41 patients) were on a normal diet. Initial concentration of TBA-rp was 2,50 ± 0,36 nmol / ml, SOD activity -21,63 ± 4,21%, catalase - 3,82 ± 1,09%. Characteristic changes in oxidation-antioxidant system of plasma were a tendency to increase the concentration of TBA-rp on the first day after surgery by 16%, decreasing to 10 th day before 1,06 ± 0,33 nmol / ml (2.4 times) and gradual decrease in activity of enzyme systems. Maximum SOD activity was registered on the fifth day - 28,58 ± 4,88% (132% dooperatsi onnogo-level), to ten days the enzyme activity fell by up to 80% of baseline. Catalase activity after surgery gradually declined by 26%.
Study group (81 persons) in addition to the food took a biologically active supplement many years of production companies ART LIFE. The product contains vegetable complex anti-inflammatory action, as well as natural AB: Vitamin C, bioflavonoids lemon, rutin, quercetin, ubiquinone, glutathione, SOD, sodium selenite in physiological doses.
BAA ART LIFE has many years of registration certificate № 002940 center hygienic certification of food products at the Institute of Nutrition and is recommended for the implementation of the population. The drug was administered for 4-5 days before surgery and after surgery from the day of the diet number 0 to 2 tablets 2 times daily with meals. The rationale for the use of dietary supplements such was the scarcity of many natural orbitals in nutrition of patients. Thus, the study of dietary 500 surgical patients, we conducted in 2001-2002. on the basis of the Kemerovo regional hospital, revealed a profound imbalance in the consumption of natural AO. On the background of high consumption of vitamin E (133%) provision of vitamin C intake was 100%, Vitamin A - 55%, beta-carotene -28% (with 50% digestibility), Mn - 80%, zinc - 56%, selenium - 20% of the recommended standards of consumption. Enrichment of the diet of patients with alimentary SA significantly improved the antioxidant defense system of the organism in the postoperative period. In almost identical preoperative indicators in both groups of patients the main group after the operation there was a gradual decrease in the concentration of TBA-rp and a high enzyme activity during the postoperative period. To ten days after the operation the activity of SOD was 26,88 ± 3,36%, respectively, in control - 17,27 ± 2,12%; catalase activity on the fifth postoperative day was 5,30 ± 1,56% and 3.22 ± 1,46%, on the tenth day 5,01 ± 1,27% and 2,84 ± 0,79%; concentration of TBA-rp to the fifth days of the main group - 1,67 ± 0,36 nmol / ml ( Control - 2,60 ± 0,57 nmol / ml), reaching statistically significant differences (p <0.05 and below). The concentration of alpha-tocopherol in plasma remained virtually unchanged before and after surgery did not significantly differing in both groups. The use of dietary supplements helped reduce the severity of inflammation after surgery.
In the control group, postoperative fever was recorded in 66% of patients with an average temperature of 37,6 ± 0,4 4,2 ± duration of 3 days, in the main - 33% of patients with an average temperature of 37,4 ± 0,3 3,0 ± duration 1.8 days. On the fifth day after the operation in the common blood tests in patients of the group no young forms of white blood cells, in contrast to the control group, and was less pronounced shift of band. To ten days ESR was lower in 1,7 times (p <0,005) than in the control group. Concentration in the plasma protein "acute phase" of ceruloplasmin in the control group increased from 297,8 ± 63,2 to 416,1 ± 104,1 to ten days. In the study group did not change the concentration of ceruloplasmin (253,4 ± 75,5 and 274,2 ± 81,9, respectively). By the fifth days of the differences in the concentrations of ceruloplasmin in patients with the control and main groups were statistically significant (p <0,05).
Thus, the use of dietary supplements ART LIFE MNOGOLET of significantly improves metabolic processes in the postoperative period and grounded in nutrition geriatric surgical patients.