Khirurgiia
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Comparative Study
[Use of ozone therapy and hydro-pressure technologies in complex intensive therapy of surgical sepsis].
Results of treatment of 214 patients with severe sepsis and septic shock were analyzed. 125 patients treated with various methods of ozonotherapy and hydropressive sanation of infectious foci formed the study group. Control group consisted of 89 patients treated according to generally accepted principles. Comparative analysis of treatment efficacy was carried out with numerous laboratory and instrumental study methods. It is shown that ozonotherapy and hydropressive technologies reduced a lethality from 39.2% in the control group to 25.6% in the study group.
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Comparative Study
[Extracorporeal detoxication in combined treatment of surgical sepsis].
The methods of extracorporeal detoxication acquire special importance in combined treatment of sepsis. The sessions of plasmapheresis, hemodialysis and isolated ultrafiltration were performed in 61 of 83 patients with sepsis. ⋯ It is difficult to select the dose of antibiotics and immunodrugs in permanent round-the-clock ultrafiltration since the part of them are eliminated through the filters. Overall lethality was 20.4% (17 of 83 patients died), in the group of patients with severe polyorganic insufficiency and septic shock who needed extracorporeal detoxication--27%.
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Experience with ultrasonic examination (USE) in diagnosis of foreign abdominal bodies in 23 patients is reviewed. Foreign abdominal bodies have specific echosemiotics. ⋯ It is necessary for this to use additional X-ray and endoscopic methods. USE helps to decide on optimal surgical approach and gives information for repeated surgery that permits to reduce the time of relaparotomy.
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Results of treatment of 37 patients with advanced purulent mediastinitis are presented. The cause of mediastinitis in 27 patients was perforation of the esophagus, in 10--purulent diseases of head and neck. Lethal outcome was in 9 (24.3%) cases. Sepsis and progression of mediastinitis were the main causes of lethal outcomes.
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The experience of diagnosis and treatment of heart and pericardium wounds in 152 patients are presented. In obecure diagnosis the authors prefer X-ray examination and echocardiography. Total lethality was 23.6%. ⋯ The left anterolaferal thoracotomy is the optimum approach in wounds of the heart and pericardium. The most frequent complication of postoperative period is pericarditis, its echographic symptoms were revealed in 91% examinys. Non-steroid and steroid antiinflammatory drugs are effective for prophylaxis and treatment of pericarditis.