Khirurgiia
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79 patients with gunshot bullet wounds of thorax and abdomen were observed. Thoracoabdominal wounds were observed in 37 cases, abdominothoracic wounds - in 35 cases. 7 cases of longitudinal non-penetrating thoracic and abdominal wounds were particularly investigated. The wound canal started in soft tissues of anterior thoracic wall and passed through the thick layers of anterior abdominal wall to the perineum. Lateral blow due to high kinetic energy of bullets caused severe damage of the ribs, lungs and abdominal organs without diaphragm lesions.
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Basing on the largest experience in the country, authors characterize the dynamics of growth, localizaton and severity of wounds from traumatic (nonlethal) weapon. Every third victim with neck wound had deep neck structures damage. Open wounds of thorax and abdomen, though performed from traumatic weapon, pose a certain life threat.
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Treatment approaches of patients with thoracoabdominal aneurysms and aortic dissections type B should be individual. Risk ratio of surgery itself and progression of non-operated disease, such as aneurysm rupture, is the determining factor in defining pro et contra surgical treatment.
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Data of 53 patients, operated on infrarenal aorta and large vessels were analyzed. Different combinations of nonopioid drugs were compared, used postoperatively. ⋯ Inclusion of paracetamol allowed faster pain relief and decrease of tramadol intake. In patients with an increased ulcer risk, postoperative analgesia should be based on paracetamol and tramadol.
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Highs and lows of infusion therapy for the treatment of the acute blood loss were studied experimentally and in clinic. Colloid and crystalloid solutions, being hemodilutants, do not transport oxygen, causing, therefore, several complications in recipient's organism. Dilutional anemic and lead to heart insufficiency, which, by-turn, cause the so called dilutional circulatory hypoxia.