Khirurgiia
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Case Reports Comparative Study
[Treatment of patients with foreign bodies in rectum].
The analysis of treatment results in 112 patients with foreign bodies in the rectum, aged from 16 to 80 years, was carried out. 99.1% of the patients were men. All the patients were examined and treated in proctology department of the Moscow municipal clinical hospital N 67 from 1969 to 1998. The examination was made by standard scheme, including rectal touch, rectoromanoscopy, X-ray and ultrasonic examinations. ⋯ When small foreign bodies could not be reached by finger, they were removed through rectoscope. Foreign bodies of big sizes, proximal end of which was in the sigmoid colon, were removed under anasthesia with the help of the assistant who fixed the foreign body through the abdominal wall in the left ileac region. In impossibility of the subject removal by these methods and presence of complications (perforation, peritonitis), laparotomy with subsequent transanal subject removal without colon section was performed, in case of perforation--with wound suturing or colostomy.
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Care results in 48 patients (male--38, female--10) with heart wounds (HW) were analyzed. 40 (83.2%) patients had stab-incised wounds, 7 (14.7%)--stab wounds, 1 (2.1%)--gunshot wounds. 23 (47.8%) patients were hospitalized in consciousness, 17 (35.3%)--in unconsciousness, 8 (16.9%)--in twilight state. The lethality among the latter two groups of the patients was 64%, in the former group--13%. 19 patients from 48 died: in preoperative period--3, during operation--10, in early postoperative period (more than 10 days)--2 patients. ⋯ In unstable hemodynamics it is necessary to carry out adequate infusion therapy, in obvious signs of heart tamponade the pericardium puncture must be performed. In agonizing patients, and in case of general anesthesia delay, it is necessary to begin thoracotomy before general anesthesia.
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Comparative Study
[Systemic inflammatory response syndrome and sepsis in maxillofacial surgery clinic].
A total of 106 patients with surgical infection in maxillofacial region were studied. Clinical and laboratory diagnostic data on surgical infection and sepsis in maxillofacial surgery are presented. Integral indices of blood circulation, respiration, brain and liver metabolism, regarding severity of surgical infection were determined. Pathogenetically substantiated therapy of sepsis is proposed.
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Comparative Study
[Complex use of ultrasound in the diagnosis and treatment of surgical diseases of the lung and pleura].
Since 1980 the N. N. Burdenko Faculty Surgical clinic, I. ⋯ Ultrasound was used in intraoperative diagnosis of peripheral lung tumors for the first time. The use of low-frequency ultrasound for the intraoperative prevention of acute postoperative pleural empyemas promotes reliable sanitation of the pleural cavity, as confirmed by bacteriologic control data. Timely rethoracotomies with low-frequency ultrasound treatment of the pleura promote more rapid inflammation elimination in the pleural cavity and prevents irreversible complications.
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Comparative Study
[Surgical treatment of extraperitoneal rectal and perineal injuries].
The aim of this study was to analyse the results of the treatment of extraperitoneal rectal and perineal injuries for 153 patients. All the patients were examined according to the scheme. ⋯ The method allows to avoid colostomy and its subsequent operative closing in extraperitoneal injury of the rectum. The method of surgical treatment is recommended in extraperitoneal rectal and perineal injuries.