Characteristics of Nutritional Detoxification Therapy in the Perioperative Period in Patients with Pancreatic Diseases

The aim was to study the effectiveness of including remaxol in nutritional detoxification therapy in the perioperative period in patients with pancreatic diseases. Material and methods. The results of treatment of 55 patients were analyzed. In the nutritional detoxification therapy regimen in the perioperative period, Impact®Oral (orally, 3 sachets per day 5 days before surgery and 7 days after) were prescribed, and in the main group (N = 44) remaxol (inosine + meglumine + methionine + nicotinamide + succinic acid) was additionally prescribed: 400.0 ml intravenously by drip according to the regimen: 2 days before surgery daily and in the postoperative period — every other day, a course of 6 drips. Patients of the control group (N = 11) received a 5% glucose solution in comparable volumes in the infusion therapy regimen. The severity of pancreatitis was assessed using the M-ANNHEIM scoring system and the M-ANNHEIM severity index, while the severity of intoxication syndrome was assessed according to Chernov V. N. et al. The nutritional status was assessed using the NRS 2002 scale and the nutritional risk index was calculated. The levels of total protein, albumin, urea, creatinine, blood amylase, and transaminases, as well as the leukocyte intoxication index, were determined dynamically (before surgery and 9 days after it). Results. The inclusion of remaxol increased treatment effectiveness, which was manifested by more pronounced positive dynamics of clinical (ALS severity, improved well-being, and restoration of appetite) and laboratory data (reduced amylase and transaminase levels, LII), as well as correlated with a decrease in the severity of nutritional deficiency. No adverse events were detected during the use of the drug; all patients received full treatment. Conclusion. When planning therapy for patients with pancreatic diseases in the preoperative period, it is necessary to assess the degree of nutritional deficiency and perform its perioperative correction. The results obtained may serve as a basis for further research in this area.

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