The present invention relates to medicine, namely to methods of treatment of acute purulent pyelonephritis, can be used in urology and abdominal surgery. Despite the use of modern methods of treatment of purulent pyelonephritis, including anti-inflammatory, surgical, hemosorption, mortality in destructive forms of pyelonephritis remains high and almost not decreased in recent years and ranges from 20-50% (Nagapattan 1998, Mgebrov 2002). This high mortality is due largely to heavy endogenous intoxication, caused by the decay products of fabrics, Exo and endotoxins, phenols, entering the blood from the kidney. Removal of toxins and microbial bodies there hemosorption from the blood of the proposed Umelochim (1978), and the method of local treatment of purulent process in the kidney and perirenal space, i.e. redevelopment of the RAS in the kidney and perirenal tissue, from which the existing pus endo - and exotoxins enter the bloodstream. Still pus from parametria was removed with passive drainage - vinyl chloride tubes, cotton-gauze drains, which are very bad. Used end-to-end washing retroperitoneal space (Nagapattan 1998; Ibilitv 1998). The prototype. As the prototype used the way Humopehy extracab the General detoxification of the human body by the method of hemosorption. The method of hemosorption is the removal of blood toxins, microorganisms, viruses, etc. by way of adsorption and absorption of their coal sorbents, skipping extrakorporale the person's blood stream through activated carbon at different sorption devices. The disadvantage of hemosorption is that they purify the blood and pus on the kidney and perirenal tissue is not removed.

The PURPOSE of the INVENTION

The aim of the invention is to develop a method of treatment of purulent pyelonephritis by direct removal of pus from the infection.

The invention

The invention consists in the following: to improve drainage of pus from the perirenal fat and the kidneys we applied drain-column with activated carbon, i.e. poorly. As it happens when hemosorption, sorbents must be able absorption and adsorption of pus, water, urine, white blood cells, red blood cells, microorganisms and toxinogenesis wound material (low and medium molecular compound metabolic end products of the decay of tissues and excessive purulent fluid from parametria) of perirenal space and from the kidneys. For an active drainage-peobably use columns of coarsely porous (pore sizes of 2.5-4.0 nm) cellophane or coarse (similar to semi-permeable membranes) p is Merom 15-20 cm in length and with a diameter of up to 2-2,5 cm introduced in the middle of perforated vinyl chloride tube and fill this column activated carbon-simplex F. (figure 1). Drain-column for jabsorb perirenal space is shown schematically in figure 1, where

POS 1. Column of porous cellophane. (Pore sizes of 2.5-4 nm).

POS 2. Column filled with activated charcoal brand simplex F.

POS 3. In the middle column perforated vinyl chloride tube.

A specific example of the method.

Before you can use these speakers (the volume of drainage speakers about 50-60 cm³with activated carbon on the sick, we decided to test them in Vitro. For this purpose, sterile half-liter jar filled with pus obtained when draining the kidney during surgery about purulent pyelonephritis and was installed in her drainage with activated carbon, and the last was pumped this pus in another the same jar for 5 hours.

The scheme of the drain-column shown in figure 2, where

POS 4. Jar filled with pus.

POS 5. Empty jar, similar to the first.

POS 6. Drainage water heater installed in both banks.

POS 7. Pus in the first jar there in 5 hours.

POS 8. The second Bank, filled with pus, pumped drainage with activated charcoal.

When the repetition of the same experience with chlorovinyls drainage tube pus remains in full in the jar, where it was injected initially, and not transferred to another.

Pus, pumped by a column with activated is the first coal banks from one to another (figure 2), becomes lighter on the eyes. When using the microscope pus in 1 jar it is determined by a large number of microbes (microbial number - 10.10), erythrocytes and leukocytes. And after passing through a column of activated carbon erythrocytes and leukocytes reduced to 10-20 in the field of view, and the number of microbial bodies to 10.3 Art. Thus, the experience of in Vitro shows that the drain-column with activated charcoal works very actively and the sorbent adsorbs and absorbs itself decomposing blood cells and microbial bodies, which are found in the pus. After studies conducted In Vitro, we began local posibly drain-column on people and purulent pyelonephritis. Drainage was installed so that he entered into the abscess cavity, the cavity is infected brush, "lying" on the ground dense location pustules after decapsulate the kidneys and passed on the locations of future accumulations of pus, blood, urine. These drains were used in 22 patients. And the result was that the drain-column worked better than vinyl chloride tube, and on the effectiveness of it exceeds 3 times. Already in the first day post-operative period, the volume of removed liquid is increased in 3 times. Not only increases the number of allocated purulent fluid, but there is a sharp cleansing it after posible, the number of eritr is Titov and leukocytes, microbial bodies in it decreases sharply. If the number of microbial bodies of pus was 10.10 century, after passing it through activated carbon number of them is reduced to 10.3 degrees, i.e. confirmed the data obtained in Vitro. Moreover, purified and pus still in the retroperitoneal space. We also conducted the analysis of the 2 groups of patients to study the effects of local posible on for purulent pyelonephritis, which also showed a high effectiveness of this method.

1 group (20 people) - traditional treatment.

group 2 (20 patients), additionally in the postoperative period was used posible of the perirenal space drainage-column.

To do this, in the abscess cavity and on the surface of decapsulated kidney installed 1-2 drainage-column for adsorption.

Drains were removed on days 2-3, if necessary set new ones. While most patients, the wound healed by primary intention in contrast to the method, where the drainage of the retroperitoneal space was carried out up to 18-20 days. Set the size of the pores in the column of plastic sheeting or sheeting and activated carbons (2,5-4,0 nm) can penetrate into the cavity of the column to adsorb and absorb activated carbon toxicodermii wound material, low and medium molecular compounds, microorganisms. In the first with the TCI postoperative period, the amount of wound fluid was tripled. The dynamics of the inflammatory process was evaluated on 1-3, 1-9 and 14-21 days according to the following criteria: body temperature, erythrocyte sedimentation rate, leukocyte index of intoxication (LII), the main indicator of intoxication (GPI), a middle-sized molecules (SMP). The original condition of the patients met all the criteria did not significantly differ (p/0,05). In the following significant differences (^*-R 0,05 - 0,001 to the source:^**-p 0.05-0.001 to control group).

In patients of the 2nd group in the earlier period was normalized body temperature, decreased toxicity (LII, SMP). Application for detoxification of the drain-column activated charcoal in patients OGP accelerates normalization of the General condition and restore the urodynamics of the operated kidney, which proves the results: reduced hospital stay 2 groups of 1.2-2.7 days. Clearly visible is the restoration of the urodynamics of the affected kidney, which allowed earlier to remove nefrologicheskie drainage (27,3+1,2, 23,2+0,7) groups respectively. Thus, we proposed a comparative analysis revealed a beneficial effect of active drainage speakers on the course of the wound process, and reduced toxicity.

The method of treatment of purulent pyelonephritis, including drainage for drainage of pus from the perirenal tissue, characterized in that cosponsor drain-column, made of cellophane with a pore size of 2.5-4.0 nm or coarse size 15-20 cm in length and diameter to 2.0-2.5 cm, filled with activated charcoal to put in the middle of perforated vinyl chloride pipe drains installed in the abscess cavity and on the surface of decapsulated kidney, for 2-3 day drains are removed, if necessary install new drains.