Morphofunctional Changes of Spleen After Hemostasis by Nonequilibrium Plasma

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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.


E. V. Semichev

Siberian State Medical University, Tomsk, Russian Federation

Author for correspondence.
Email: evsemichev@yandex.ru

Russian Federation

кандидат медицинских наук, научный сотрудник ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (923) 401-81-60

A. N. Baikov

Siberian State Medical University, Tomsk, Russian Federation

Email: baikov47@mail.ru

Russian Federation

заведующий ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101

N. M. Shevtsova

Siberian State Medical University, Tomsk, Russian Federation

Email: nata_m_shevtsova@mail.ru

Russian Federation

старший научный сотрудник ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101

B. S. Bushlanov

Siberian State Medical University, Tomsk, Russian Federation

Email: pavel.vivian@gmail.com

Russian Federation

клинический ординатор кафедры хирургических болезней педиатрического факультета СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101

E. A. Gereng

Siberian State Medical University, Tomsk, Russian Federation

Email: e-gereng@mail.ru

Russian Federation

старший научный сотрудник ЦНИЛ СибГМУ Адрес: 634050, Томск, Московский тракт, д. 2, тел.: +7 (3822) 911-101

A. N. Aleinik

National research Tomsk polytechnical university, Tomsk, Russian Federation

Email: aleinikan@mail.ru

Russian Federation

старший научный сотрудник кафедры прикладной физики ФТИ ТПУ Адрес: 634050, Томск, пр-т Ленина, д. 30 , тел.: +7 (3822) 60-63-33

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