Changes in the care of peripheral vascular disease at the University of Szeged

Zsolt Palásthy, Róbert Sipka, Gábor Mihalovits, Tibor Takács, László Leindler, Zoltán Hódi, Rita Váradi, Áron Nyilas, Endre Nagy, András Nagy, Andrea Vass, Zoltán Ruzsa, Gábor Bogáts, György Lázár
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Abstract

Introduction and aims. In recent decades health care changes have accelerated enormously. Previously, by learning an effective procedure, the doctor could guarantee his patients the highest level of care for many years. Nowadays, due to the dynamics of development, the renewal cycles of the methods have been shortened, without continuous learning and training, it is already inconceivable to provide the up-to-date care required by patients. Patients and methods. Instead of vascular replacements with prosthetic grafts, which played an important role in vascular reconstructions, the primacy of endovascular techniques has become decisive. It can be significant for aortic aneurysms that can be operated with high invasiveness. The learning of catheter techniques by vascular surgeons made it possible to treat more successfully those limb-threatening cases, which are often associated with extensive vascular involvement, through the so-called hybrid operations. In addition to the increasing prevalence of diabetes worldwide, the higher proportion of critical limb ischemia and the highlighted pathogenic role of multi-resistant bacteria in the disease caused the marginaliation of the use of previously preferred prosthetic grafts. The effectiveness of the treatment of graft infections, which thus become less frequent, is improved by the use of homografts and negative pressure therapy. An effective method of preventing stroke is carotid endarterectomy, the morbidity of which is reduced by the introduction of locoregional anaesthesia allowing direct neuromonitoring. Results/conclusions. Although the acquisition and implementation of new methods has posed a continuous challenge for our specialists and doctors over the past 10 years, our achievements have made our department one of the leading vascular surgery centres in the country.

塞格德大学周围血管疾病护理的变化
介绍和目的。近几十年来,医疗保健的变化大大加快。以前,通过学习一种有效的程序,医生可以保证他的病人多年来得到最高水平的护理。如今,由于发展的动力,方法的更新周期缩短了,没有持续的学习和培训,已经无法提供患者所需的最新护理。患者和方法。代替在血管重建中发挥重要作用的人工血管置换,血管内技术的首要地位已成为决定性的。对于可进行高侵入性手术的主动脉瘤,这是非常重要的。血管外科医生对导管技术的学习使得通过所谓的混合手术更成功地治疗那些威胁肢体的病例成为可能,这些病例通常与广泛的血管介入有关。除了全球范围内糖尿病患病率的上升外,严重肢体缺血比例的上升以及多重耐药细菌在该疾病中的突出致病作用,导致先前首选的假肢移植物的使用被边缘化。移植物感染的治疗效果因此变得不那么频繁,通过使用同种移植物和负压疗法得到改善。预防中风的一种有效方法是颈动脉内膜切除术,其发病率通过引入局部区域麻醉而降低,允许直接神经监测。结果/结论。虽然在过去的10年里,新方法的获取和实施对我们的专家和医生提出了持续的挑战,但我们的成就使我们的部门成为全国领先的血管外科中心之一。
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