EFFECTIVENESS OF LOCAL APPLICATION OF FIBRINOLYTIC DRUGS TO REDUCE THE NUMBER OF COMPLICATIONS IN PATIENTS WITH MAXILLARY AND ZYGOMATIC BONE FRACTURES

Authors: Maksym NAZAREVYCH, Roman OHONOVSKYI, Khrystyna POHRANYCHNA, Ihor LOMNYTSKY, Oleh MOKRYK, Yuriy MELNYCHUK, Stasyshyn ANDRIY2

Abstract:

Introduction. The main purpose of this research was to study the effectiveness of local fibrinolytic therapy in the rehabilitation of patients with traumatic injuries of the zygomatic-orbital complex.  Materials and methods. Patients in the control group (15 persons) received in the postoperative period standard antibiotic therapy, and analgesic, anti-inflammatory and anti-edematous therapy. Patients in the main group (17) received into the parabulbar tissues an additional injection of „Hemase” 5000 ME once a day, for 4-5 days. The effectiveness of the treatment was compared by determining the state of microcirculation, sensory sensitivity and level of enolase in the venous blood.  Results and discussion. The general conjunctival index in the control group was 18.9 ± 1.2 points on the 7th day and 16.1 ± 1.8 points on the 14th day, and 15.7 ± 1.0 (p <0.05) and 11.7 ± 1.1 points (p <0.05), respectively, in the experimental one. The threshold of electrical excitability of the infraorbital nerve in patients of the control group on the 7th day was 68.4 ± 5.2 μA, while in the main one – 48.1 ± 5.3 μA (p <0,05). On day 14, the difference in the excitability threshold was even more pronounced: in the control – 52.9 ± 4.8 μA, in the main group – 33.2 ± 3.4 μA (p <0.05), with the index on the  healthy side at 27.1 ± 1.9 μA. It was also found out that, in the control group, the level of enolase on both the 7th and 14th day exceeded the values ​​obtained during the examination of patients in the main group: 24.5 ± 1.5 ng/ml to 19 , 4 ± 1.3 ng/ml and 15.6 ± 1.4 ng/ml to 15.1 ± 1.5 ng/ml. Conclusions. The obtained data allowed stating that application of the proposed course of postoperative rehabilitation helps restore the conduction of nerve trunks, has an anti-edematous effect on the soft tissues of the infraorbital area and improves the hemodynamics of the suborbital artery and vein.

Keywords:
  • fibrinolitic drugs
  • zygomatic-orbital fractures