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Morphofunctional Changes of Spleen After Hemostasis by Nonequilibrium Plasma
- Authors: Semichev E.V.1, Baikov A.N.1, Shevtsova N.M.1, Bushlanov B.S.1, Gereng E.A.1, Aleinik A.N.2
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Affiliations:
- Siberian State Medical University, Tomsk, Russian Federation
- National research Tomsk polytechnical university, Tomsk, Russian Federation
- Issue: Vol 70, No 5 (2015)
- Pages: 592-598
- Section: SCIENTIFIC REPORTS
- Published: 03.12.2015
- URL: https://vestnikramn.spr-journal.ru/jour/article/view/553
- DOI: https://doi.org/10.15690/vramn.v70.i5.1447
- ID: 553
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Abstract
Background: Heavy bleeding is developed in case of spleen injury. It often leads to death. At present the search and development of new methods for hemostasis of spleen bleeding continues. An innovative method is coagulation of nonequilibrium plasma.
Objective: Our aim was to study the effect of nonequilibrium plasma on the morphofunctional state of the spleen.
Methods: The non-randomized study by type of «case-control» was conducted. The experiment was carried out on 45 male rabbits weighing 3000–3200 g. 1st group (control; n =5) — intact animals without surgery; 2nd group (experimental, n =40) — animals after atypical resection of the spleen and hemostasis by nonequilibrium plasma. The volume of blood loss, FBC, histological data, splenogram analysis data were assessed at defined periods (60 min, 3rd, 5th, 7th, 14th, 30th, 90th, 180th days) after surgery. They were compared with data of the control group.
Results: The volume of blood loss during the resection of the spleen with hemostasis by nonequilibrium plasma was 16.6 [15.98;17.22] ml. Increase of neutrophil to 38 [24; 39] (control group 17 [13, 18], p =0.009), monocytes to 15 [14, 18] (control group 8 [6, 11], p =0.036) is revealed in the FBC in the early period after hemostasis with nonequilibrium plasma. It is reduced to the norm on 30 day. Histological examination revealed leukocyte infiltration, edema, microvascular stasis, dilatation of vessels in the early period. At long-term period structure of the organ is normalized. Splenogramm analysis revealed a statistically significant (p =0.023) decrease in the relative number of small lymphocytes by 28% in animals after hemostasis with nonequilibrium plasma as compared to control (23.3 [17.9; 26.7] versus 30.8 [29.25; 34.3]
respectively).
Conclusion: treatment of bleeding surface by plasma flow for 1.5–2 min is required order to achieve effective hemostasis during surgery
of spleen injuries in the experiment. After coagulation there is minimal damage of the spleen parenchyma, which manifests itself as activation reaction. At long-term period parenchyma of the spleen completely regenerates with the formation of cicatrical tissue that does not affect the functioning of organ.
About the authors
E. V. Semichev
Siberian State Medical University, Tomsk, Russian Federation
Author for correspondence.
Email: evsemichev@yandex.ru
кандидат медицинских наук, научный сотрудник ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (923) 401-81-60
РоссияA. N. Baikov
Siberian State Medical University, Tomsk, Russian Federation
Email: baikov47@mail.ru
заведующий ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101
РоссияN. M. Shevtsova
Siberian State Medical University, Tomsk, Russian Federation
Email: nata_m_shevtsova@mail.ru
старший научный сотрудник ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101
РоссияB. S. Bushlanov
Siberian State Medical University, Tomsk, Russian Federation
Email: pavel.vivian@gmail.com
клинический ординатор кафедры хирургических болезней педиатрического факультета СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101
РоссияE. A. Gereng
Siberian State Medical University, Tomsk, Russian Federation
Email: e-gereng@mail.ru
старший научный сотрудник ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101
РоссияA. N. Aleinik
National research Tomsk polytechnical university, Tomsk, Russian Federation
Email: aleinikan@mail.ru
старший научный сотрудник кафедры прикладной физики ФТИ ТПУ Адрес: 634050, Томск, пр-т Ленина, д. 30 , тел.: +7 (3822) 60-63-33
РоссияReferences
- ПPopov V.A. Gemostaz i germetizatsiya shvov (operatsii na vnutrennikh organakh) [Hemostasis and Sealing of Joints (Operation on the Internal Organs)]. Moscow, GEOTAR-Media, 2008. 320 p.
- Savel'ev V.S., Kirienko A.I. Klinicheskaya khirurgiya. Natsional'noe rukovodstvo. T. II [Clinical Surgery. National Guidelines. Vol.2]. Moscow, GEOTAR-Media, 2009. 401 p.
- Ahmed N., Vernick J.J. Management of liver trauma in adults. J. Emerg. Trauma and Shock. 2011; 4 (1): 114–119.
- Alkozai E.M., Lisman T., Porte R. J. Bleeding in liver surgery: prevention and treatment. Clin. Liver Dis. 2009; 13 (1): 145–154.
- Makhnev A.V., Strelin S.A., Shneider V.E., Volkova Yu.L. Patent na izobretenie RUS 2421159 22.06.2009. Sposob ostanovki krovotecheniya pri travmakh pecheni. Opubl. 27.12. 2010 [Patent for the Invention RUS 2421159 22.06.2009. A Method of Stopping Bleeding in Liver Injury. Published 12.27.2010].
- Kubachev K.G., Kukushkin A.V. Diagnosis and surgical tactics in isolated and combined liver injury. Sibirskii meditsinskii zhurnal (Irkutsk) = Siberian medical journal (Irkutsk). 2010;92(1):119–122.
- Shchegolev A.A., Platonov D.V., Marushchak E.A. Closed abdominal trauma: strategy surgeon at damages the liver and spleen. Lechebnoe delo = Medical care. 2007;3:73–78.
- Carus T., Rackebrandt K. Collateral tissue damage by several types of coagulation (monopolar, bipolar, cold plasma and ultrasonic) in a minimally invasive, perfused liver model. ISRN Surg. 2011; 2011: 518924.
- Choi S.H., Lee J.M., Lee K.H., Kim S.H., Lee J.Y., Han J.K., Choi B.I. Postbiopsy splenic bleeding in a dog model: comparison of cauterization, embolization, and plugging of the needle tract. Am. J. Roentgenol. 2005. 185 (4): 878–884.
- Deneko O.I., Aleinik A.N., Semichev E.V. Plazmennaya meditsina. Uchebnoe posobie [Plasma Medicine. Tutorial]. Saarbrücken, Palmarium Academic Publishing, 2013. 93 p.
- Semichev E.V., Borodin O.Yu., Bushlanov P.S. Experimental surgery parenchymal organs (review). Russkii meditsinskii zhurnal = Russian medical journal. 2012;20(36):1743–1746.
- Tikhonov V.I., Popov O.S., Shpilevoi P.K. Krovotechenie. Perelivanie krovi. Uchebno-metodicheskoe posobie [Bleeding. Blood transfusion. Textbook]. Tomsk, TGU, 2005. 148 p.
- Kalghatgi S.U., Fridman G., Cooper M., Nagaraj G., Peddinghaus M., Balasubramanian M., Vasilets V.N., Gutsol A.F., Fridman A., Friedman G. Mechanism of Blood Coagulation by Nonthermal Atmospheric Pressure Dielectric Barrier Discharge Plasma. IEEE 34th International Conference. 2007. 674 p.
- Balasubramanian M., Fridman G., Brooks Ari D., Fridman A., Gutsol A.F., Vasilets V.N., Halim A., Friedman G. Comparison of Direct and Indirect Effects of Non-Thermal Atmospheric-Pressure Plasma on Bacteria. Plasma Process Polym. 2007; 4: 370–375.
- Fridman G., Friedman G., Gutsol A.F., Shekhter A.B., Vasilets V.N., Fridman A. Applied Plasma Medicine. Plasma Process Polym. 2008; 5: 503–533
- Moldoveanu C., Geavlete B., Jecu M. Stanescu F., Adou L., Bulai C. Bipolar plasma vaporization versus monopolar TUR and «cold-knife» TUI in secondary bladder neck sclerosis — An evidence based, retrospective critical comparison in a single center clinical setting. J. Med. Life. 2014. 7 (1): 94–99.
- Gonokhova M.N., Boiko T.V., El'tsova A.A. Comparative cytomorphological characteristics of rats’ spleen exposed to pesticides. Sovremennye problemy nauki i obrazovaniya = Modern problems of science and education. 2013;6:1056.
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