Klinicheskaia khirurgiia最新文献_第8页

Peculiarities of perioperative intensive therapy in patients with an acute calculous cholecystitis 急性结石性胆囊炎围手术期强化治疗的特点

Klinicheskaia khirurgiia Pub Date : 2022-01-12 DOI: 10.26779/2522-1396.2021.11-12.15

A. Denysenko, V. Cherniy

{"title":"Peculiarities of perioperative intensive therapy in patients with an acute calculous cholecystitis","authors":"A. Denysenko, V. Cherniy","doi":"10.26779/2522-1396.2021.11-12.15","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.15","url":null,"abstract":"Objective. To study perioperative changes in hemodynamics, the oxygen state and metabolism in patients, suffering an acute calculous cholecystitis, and to determine the methods of their correction. \u0000Materials and methods. The investigation was based on 131 patients, suffering an acute calculous cholecystitis, to whom laparoscopic cholecystectomy under general anesthesy was performed. The risk value, determined in accordance to classification of American Society of Anesthesiologists, have constituted Class II-ІV. The patients were divided into two groups. The first one have consisted of 63 patients, in whom intensive therapy, directed on support of vital functions, was conducted, while in a second group (68 patients) the data of indirect calorimetry were used additionally. \u0000Results. On the stage of the patients staying in reverse position of Trendelenburg, the adjustment of pneumoperitoneum and the operation beginning the lowering of hemodynamics indices, the oxygen state and metabolic disorders have had more pronounced features in patients of the first group, and their restoration was more durable. The second group patients on background of powered infusion therapy and introduction of glucocorticoids were restored more intensively, they woke up more early, the intensive department stay was shorter, emesis and regurgitation have occurred in them in 2.4 times more rarely, and severity of postoperative pain after waking up was lower (р < 0.05). \u0000Conclusion. In patients, suffering an acute calculous cholecystitis, laparoscopic cholecystectomy is more secure on background of the hemodynamics, the oxygen state and metabolism corrected.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78572176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disconnected pancreatic duct syndrome 胰管断连综合征

Klinicheskaia khirurgiia Pub Date : 2022-01-12 DOI: 10.26779/2522-1396.2021.11-12.80

S. Chooklin, S. Chuklin, R. Barylyak

引用次数: 0

Dynamics of contractile function of the left atrium in patients, suffering ischemic mitral regurgitation 缺血性二尖瓣反流患者左心房收缩功能的动态变化

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.7-8.21

S. Musayev, E. Gurbanov

{"title":"Dynamics of contractile function of the left atrium in patients, suffering ischemic mitral regurgitation","authors":"S. Musayev, E. Gurbanov","doi":"10.26779/2522-1396.2021.7-8.21","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.7-8.21","url":null,"abstract":"Objective. Estimation of mechanical function of the left atrium in patients, suffering an ischemic mitral regurgitation, using technology of the vector analysis of the endocardium movement speed. \u0000Materials and methods. Into prospective cohort of non-randomized investigation 107 patients ageing (56 ± 7.5) yrs old, 96 (89.7%) of them are men, were included. There were following criteria of selection: the Degrees I-III of ischemic mitral regurgitation by echocardiographic data, angiographically revealed an ischemic heart disease, demanding surgical revascularization, the sinus rhythm with the heart rate frequency from 60 to 89 in 1 minute, the improved echocardiographic visualization of the left atrium endocardium. \u0000Results. The indices of mechanical function of the left atrium are lowering in proportion to degree of severity of the ischemic mitral regurgitation. Longitudinal deformity and speed of the left atrium deformity reflects connection with the ischemic mitral regurgitation more, than conventional indices, applied for estimation of the left atrium geometry. The data obtained witnesses thet comparable ultrastructural changes in atrium, occurring in chronic volume overload of mitral regurgitation from Degree II and higher. The changes and velocity of the atriums deformity may be associated with severity of regurgitation. \u0000Conclusion. Significance of the left atrium mechanical function is associated with the ischemic mitral regurgitation and depends on mechanical remodeling of the left atrium. Studying of dynamics of the left atrium mechanical function in patients with mitral regurgitation may appear perspective and beneficial while doing estimation of its hemodynamical significance and choice of surgical approach as additional intervention on a mitral valve.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76601030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of modern methods of analgesia in wide hepatic resection 现代大范围肝切除术镇痛方法分析

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.9-10.80

R. А. Zatsarynnyi

引用次数: 0

Laparoscopic appendectomy in a postcovid period 后冠状病毒期腹腔镜阑尾切除术

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.7-8.11

V. V. Mіshchenko, P. I. Pustovoit, R. Y. Vododiuk, V. Velichko

{"title":"Laparoscopic appendectomy in a postcovid period","authors":"V. V. Mіshchenko, P. I. Pustovoit, R. Y. Vododiuk, V. Velichko","doi":"10.26779/2522-1396.2021.7-8.11","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.7-8.11","url":null,"abstract":"Objective. Determination of the role and place of laparoscopic appendectomy in a postcovid period. \u0000Materials and methods. Laparoscopic appendectomy was performed in 73 patients, who have carried COVID–19. The Alvarado Scale was applied for verification of an acute appendicitis diagnosis. \u0000Results. The term of establishing of an acute appendicitis diagnosis in 87.7% of patients have constituted 6 h and more, while the term of preoperative observation – (12.7 ± 3.1) yr. Phlegmonous form of inflammation of processus vermiformis have constituted 61.4% of cases. Antibodies IgMSARSCov–2 (COVID–19) and IgGSARSCov–2 (COVID–19) were revealed in 100% of patients, suffering an acute appendicitis. Thus, laparoscopic appendectomy in the patients, who have carried COVID–19, is secure. \u0000Conclusion. The acute appendicitis course in the patients, who have carried COVID–19, owed certain clinical peculiarities. Diagnosis of an acute appendicitis in such patients must be rapid and precise. Appendectomy in patients in a postcovid period must be performed before the development of an acute appendicitis complications. Laparoscopic appendectomy in patients, who have carried COVID–19, must become a «gold standard» of operations in an acute appendicitis.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74365354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Photodynamic therapy in treatment of trophic ulcers in patients, suffering chronic venous insufficiency 光动力疗法在治疗慢性静脉功能不全的营养性溃疡患者中的应用

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.7-8.32

Yu. V. Іvanova, S. М. Gramatyuk, І. A. Kryvoruchko, O. O. Zarudnyi, K. Miasoiedov

{"title":"Photodynamic therapy in treatment of trophic ulcers in patients, suffering chronic venous insufficiency","authors":"Yu. V. Іvanova, S. М. Gramatyuk, І. A. Kryvoruchko, O. O. Zarudnyi, K. Miasoiedov","doi":"10.26779/2522-1396.2021.7-8.32","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.7-8.32","url":null,"abstract":"Objective. Elaboration of complex approach to treatment of trophic ulcers of venous etiology, using photodynamical tissue therapy and modern types of the wound coverage. \u0000Materials and methods. Into the investigation 24 patients were included, suffering venous ulcers on background of postthrombophlebitic disease and ageing from 31 to 79 yrs old. Into the comparison group there were included 14 patients, in whom a standard treatment (venotonic preparations, elastic compression, local application of multicomponent ointments depending on the wound phase present) was used. Into the main group10 patients were included, in whom the elaborated procedure of photodynamical therapy was applied. In treatment of the patients the Korobov’s photonic matrix «Barva Flex», owing spectral diapason 700-630 nm, corresponding to red light, was applied. Gel «Levuderm» (6% gel 5-aminolevulinic acid phosphate, which constitutes a natural predecessor of endogenous photosensitizer protoporphyrin IX) was applied. \u0000Results. Transition of the wound process to the second stage in the comparison group was durable, in 50% of patients epithelization did not complete up to 45th day of treatment. In the main group, under the impact of the treatment method proposed, the term of granulations appearance have had shortened as well as filling in of the wound by mature granulation tissue, and epithelization have accelerated by 29.8%, comparing with standard therapy. \u0000Conclusion. This investigation owes a shortage because of insufficient volume of sampling. Thus, it is necessary to perform further controlled investigations to discover the mechanisms of basic impact of the 5-aminolevulinic acid photodynamical therapy on the wound healing process.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80295944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Endovascular treatment of a giant false aneurism of suprarenal aorta 肾上主动脉巨大假动脉瘤的血管内治疗

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.7-8.93

S. N. Furkalo, I. Khasyanova, A. V. Liksunov, D. A. Prysiazhniuk

引用次数: 0

Peculiarities of application of the CT densitometric indices in the treatment of perforative pulmonary tuberculosis CT密度测量指标在穿孔性肺结核治疗中的应用特点

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.9-10.21

E. M. Mayetnyi

{"title":"Peculiarities of application of the CT densitometric indices in the treatment of perforative pulmonary tuberculosis","authors":"E. M. Mayetnyi","doi":"10.26779/2522-1396.2021.9-10.21","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.21","url":null,"abstract":"Objective. To determine the possibilities of application of the CT densitometry in treatment of perforative pulmonary tuberculosis. \u0000Materials and methods.The work is based on results of analysis ofpostoperative investigation concerning densitometric indices in pulmonary parenchyma and foci of specific affection in 75 patients, suffering hydropneumothorax. \u0000Results. There was established, that densitometric indices of pleural content, revealed while analyzing of the CT images, permits to differentiate trustworthily transudate, exudate and coagulated blood, and to determine activity of specific tuberculosis inflammation, emphysema and the pulmonary parenchyma density. Significant correlation connection of the infiltration parameters and vascular structures (97% CI) was revealed as well, what indicates on possibility of application of densitometric analysis for estimation of the treatment efficacy. \u0000Conclusion. Application of densitometric indices of CT permits to estimate the inflammatory process course in pathologically changed pulmonary parenchyma, to reveal in it the emphysematic processes and degree of atelectasis in the blocked parts.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78384487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Syndrome disconnected pancreatic duct. Part 1. Diagnostics 胰管断开综合征。第1部分。诊断

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.9-10.73

S. Chooklin, S. Chuklin, R. Barylyak

引用次数: 0

Peculiarities of surgical tactics in woundings and traumas of large bowel in the fighting environment 战斗环境下大肠外伤手术策略的特点

Klinicheskaia khirurgiia Pub Date : 2021-11-28 DOI: 10.26779/2522-1396.2021.9-10.33

K. Gumeniuk, G. A. Prokhorenko, І. Trutyak, І. P. Sobol

{"title":"Peculiarities of surgical tactics in woundings and traumas of large bowel in the fighting environment","authors":"K. Gumeniuk, G. A. Prokhorenko, І. Trutyak, І. P. Sobol","doi":"10.26779/2522-1396.2021.9-10.33","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.33","url":null,"abstract":"Objective. To raise the efficacy of the surgical aid delivery for the wounded persons, suffering fighting trauma of large bowel, on the medical evacuation stages using the improved approaches to estimation of their state of severity, diagnostic and treatment tactics, including introduction of technology of the damage control surgery. \u0000Materials and methods. The results of treatment in 23 patients with woundings and traumas of large bowel, who were distributed into two clinical groups - a control and the main one- were analyzed. Into the control group 8 wounded persons were included (2014 - 2018), in whom surgical tactics was applied, based on principles of standard coloproctology; and into the control one - 15 wounded persons (2016 - 2021), whose treatment was based on selective approach for the surgical tactics choice on the ІІ level of medical help. Average age of the patients have constituted 33 yrs old (20 - 45 yrs old), the damage severity in accordance to scale of the Injury Severity Score was estimated as 23 points at average. Taking into account, that severe state of the wounded persons of the main group have become intraoperatively poorer, to them a multi-staged surgical tactics of the damage control surgery was applied. \u0000Results. Of 15 wounded persons of the main group, in whom a differentiated choice of surgical tactics was used, taking into account the state of severity degree, volume and degree of the damages severity and technology of the damage control surgery, there have become possible to save the life of 12 patients and to obtain in them good late follow-up results. \u0000Conclusion. In wounded persons, suffering fighting trauma of large bowel, application of technology of a damage control surgery permits to prevent the life-threatening complications and to save their lives.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74250906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2