Khirurgiia
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Analysis of 102 cases of coagulated hemothorax (CH) are presented: 32--after penetrating wounds and 70--after closed chest injury. In 57% patients with chest wounds and 72% patients with closed injury the cause of CH was to applying late for medical care. ⋯ Depending on the patients state severity, CH volume and stage of it formation conservative treatment, streptase administration, thoracoscopy and thoracotomy with pleurectomy and lung decortication were performed. Lethality was 2.9%.
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A mathematical method based on a complex of capillary blood examinations was proposed and tested for detection of volume and degree of blood loss in trauma of the chest and the abdomen. This method may be used for optimization of intraoperative fluid management. It is very important when bleeding is not only into the serous cavities (blood loss is easy to evaluate during surgery) but also into the intermuscular and interstitial spaces, and also in internal hemorrhage.
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Anesthesiology is one of the most progressive medical science. Today's anesthesiologist is not only specialist in anesthetic management, he is also involved in pre- and postoperative treatment. ⋯ But absence of prestige and low salary lead to low receipt of new specialists. The article also reviews the problems of training specialists, management, future prospects of modern anesthesiology.