Background. Despite the undoubted success of modern medicine, peritonitis in children remains not only a surgical, but also a general pathological problem, the relevance of which is not decreasing. The use of efferent therapy methods, in particular hemosorption, imitating the natural mechanisms of detoxification of the body, are promising in the complex therapy of children with peritonitis. The aim of the study was to establish the effectiveness of the antiproteinase hemosorbent "Hemo-proteazsorb" in the complex intensive care of children with generalized peritonitis. Material and methods. A prospective randomized study of 60 children with generalized peritonitis was conducted. In the main group, there were 30 patients who underwent hemosorption in complex intensive therapy. The comparison group also included 30 patients who underwent traditional treatment. The examined groups were comparable in terms of the nature of the pathology and the severity of the condition. Results. During hemoperfusion, a significant increase in blood saturation was established – from 95.1 (93.2; 97.1)% to 97.3 (95.5; 98.7)%, with an improvement in oxygen transport (ctO2, mmol/l) from 6.9 (6.4; 7.9) to 8.8 (1.5; 9.7) and a decrease in lactate level (mmol/l) from 1.7 (1.5;2.1) to 1.1 (0.9;1.3), which indicated normalization of blood oxygenation and improvement of microcirculation. After 24 hours, there was a significant decrease in the sum of points on the pSOFA scale, from 4.5 (3.0; 6.0) to 0.5 (0; 2.0), p<0.001. Normalization of body temperature and restoration of intestinal function in 15 (50.0% СI 32.1-67.9) children were also noted, which indicated a decrease in multiple organ dysfunction and improvement of the condition. In the comparison group, the studied indicators changed much more slowly. Conclusions. The data on the positive dynamics of clinical and laboratory parameters, obtained as a result of the study, prove the high effectiveness of the Belarusian hemosorbent "Hemo-proteazsorb" in the complex intensive care for generalized peritonitis.

Introduction. Despite the undoubted success of modern medicine, peritonitis in children remains not only a surgical, but also a general pathological problem, the relevance of which does not decrease. The use of efferent therapy methods, in particular hemosorption, imitating the natural mechanisms of detoxification of the body, are promising in the complex therapy of children with peritonitis. Aim. The aim of the study was to establish the effectiveness of the antiproteinase hemosorbent „Hemo-proteazsorb” in the complex intensive care of children with generalized peritonitis. Material and methods. A prospective randomized study of 60 children with generalized peritonitis was conducted. In the main group, there were 30 patients who underwent hemosorption in complex intensive care, and the comparison group also included 30 patients who underwent traditional treatment. The examined groups were comparable in terms of the nature of the pathology and the severity of the condition. Results. During hemoperfusion, a significant increase in blood saturation was established from 95.1 (93.2; 97.1)% to 97.3 (95.5; 98.7)%, with an improvement in oxygen transport (ctO2, mmol/l) from 6.9 (6.4; 7.9) to 8.8 (1.5; 9.7) and a decrease in lactate level (mmol/l) from 1.7 (1.5;2.1) to 1.1 (0.9;1.3), which indicates normalization of blood oxygenation and improvement of microcirculation. After 24 hours, there was a significant decrease in the amount of points on the pSOFA scale, from 4.5 (3.0; 6.0) to 0.5 (0; 2.0), p < 0.001, normalization of body temperature, restoration of intestinal function was noted in 15 (50.0% CI: 32.1-67.9) children, which indicates a decrease in multiple organ dysfunction and improvement of the condition. When compared in the second group, the studied indicators changed much more slowly. Conclusions. The data obtained as a result of the study on the positive dynamics of clinical and laboratory parameters prove the high effectiveness of the use of the Belarusian hemosorbent ?Hemo-proteazsorb? in the complex of intensive care of generalized peritonitis.

Aim: To study the effect of the antiproteinasehemosorbent “Hemo-proteasesorb” on the dynamics of the main markers of inflammation in the complex intensive care of children with generalized peritonitis. Material and methods: A prospective randomized study of 60 children with generalizedperitonitis was conducted. Group I included 30 patients who underwent hemoperfusion through the sorbent “Hemo-proteazsorb”. Group II included 30 patients who underwent traditional treatment. The examined groups were comparable in the nature of pathology and severity of the condition. Results: After hemoperfusion, a significant decrease in the main markers of inflammation was found: C-reactive protein decreased from 83.7 (72.2; 131.3) to 12.9 (10.0;22.0) (p=0,0003) mg/l, procalcitonin level normalized from 4.65 (2.1;7.4) to 0.21 (0.07;0.4) (p=0,00002) ng/ml, presepsin level decreased from 5.7 (2.5; 8.8) to 0.4 (0.3; 0.8) (p=0,25) ng/ml, the level of IL-6 decreased from 25.3 (6.0; 68.8) to 4.6 (0.9; 8.3) (p=0.000001) pg/ml. When compared in the second group, the studied indicators changed much more slowly. Conclusions: The data obtained as a result of the study indicate a decrease in the severity of the inflammatory process, a decrease in the risk of sepsis in the group of patients who underwent hemoperfusion, and thereby prove the effectiveness of this method.

Introduction. Current trends in the diagnostics of acute appendicitis have the following main objectives: to improve the diagnostic accuracy in destructive forms; to reduce the number of negative appendectomies and diagnostic laparoscopies. Purpose. To compare the effectiveness of Alvarado and PAS scales and to find out which of them is more appropriate in the differential diagnostics of acute abdominal pain in children. Material and Methods. A prospective randomized blind clinical trial was performed. 326 children aged 5-17 years with abdominal pain were examined. Results. No significant advantages of any of the analyzed scales were found in the differential diagnostics of acute abdominal pain in children aged 5-17 years. Both scales can be used in the primary stratification of patients. With the conclusion “Acute appendicitis is likely possible,” the level of non-diagnosed cases of acute appendicitis will not exceed 3%. Conclusions. Further assessment of various scales for the diagnostics of acute appendicitis in children has to be done in order to select the optimal one. The obtained results urge to make scales’ modification so as to improve the diagnostic accuracy and to reduce the number of negative appendectomies and diagnostic laparoscopies.

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