EFFECTIVENESS OF CORRECTION OF THE OXIDANT-ANTIOXIDANT SYSTEM AND ENERGY METABOLISM DISORDERS IN CHILDREN WITH ADHESIVE INTESTINAL OBSTRUCTION

The treatment of children with adhesive intestinal obstruction (AIO) remains a significant challenge in pediatric surgery. Surgical trauma, hypoxia, postoperative intestinal paresis, intoxication, and nutritional deficiency in the perioperative period in children with AIO lead to substantial metabolic disturbances that require appropriate correction. The aim of the study. To evaluate the effectiveness of correcting oxidant-antioxidant system imbalance and energy metabolism disorders in children undergoing surgery for postoperative AIO using the L-carnitine-containing drug Cardonat. Materials and methods. The study included 53 children aged 6–14 years who underwent surgery for postoperative AIO. Of these, 27 children (50.94%) received Cardonat as part of their therapy (main group), while 26 children (49.06%) were treated with standard therapy (comparison group). The control group consisted of 20 somatically healthy children of the same age. To evaluate the dynamics of lipid peroxidation (LPO), the serum levels of primary (diene conjugates, DC) and secondary (thiobarbituric acid-active products, TBA-AP) free radical oxidation products were measured. Antioxidant defense (AOD) status was assessed by measuring the activity of glutathione peroxidase (GP), glutathione transferase (GT), and glutathione reductase (GR), as well as the concentration of ceruloplasmin. To assess changes in energy metabolism under treatment, serum levels of ATP, lactate, pyruvate, and lactate dehydrogenase (LDH) were determined. Research results. Cardonat administration resulted in a 2.2-fold reduction in DC and a 1.73-fold reduction in TBA-AP levels compared to pre-treatment values. The ceruloplasmin level increased 1.78-fold relative to pre-treatment values and did not differ significantly from that of healthy controls. The activity of glutathione redox system enzymes significantly increased in the main group compared to the traditional treatment group. In patients of the main group, the content of ATP in the blood serum increased by 2.38 times, the level of pyruvate - by 2.53 times. In the main group, ATP levels increased 2.38-fold, and pyruvate levels rose 2.53-fold. Concurrently, lactate levels decreased by 3.51 times, and LDH level decreased by 1.41 times. Conclusions. The inclusion of the L-carnitine-containing antioxidant and energy-modulating drug Cardonat in the treatment regimen for children with AIO leads to a more favorable postoperative course. It promotes a reduction in primary and secondary lipid peroxidation products, significantly enhances the activity of antioxidant enzymes, and contributes to the normalization of energy metabolism by increasing ATP levels and markedly reducing signs of lactic acidosis.