Khirurgiia
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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.
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Treatment results in 87 patients (mean age 30.1 years) with traumatic injuries of major abdominal vessels were analyzed. 73 patients had stab-incised wounds, 9--blunt trauma, 5--gunshot wounds. Hemodynamics of the majority of hospitalized patients (66 from 87) was unstable. Inferior cava vein injury was revealed in 29 patients, aorta injury--in 21, iliac vessels injury--in 22, visceral vessels injury--in 15. ⋯ Vascular operations (side suture--in 49 patients, circular suture--in 11, vein ligation--in 5, prosthesis--in 3) were performed in 17 (25%) patients by general surgeons, in the rest (75%)--by vascular surgeons. General mortality (including hospitalized but non-operated patients, and patients who died during the operation and in postoperative period) was 46%. It is necessary to teach vascular surgery to general surgeons for high-quality and timely care in patients with abdominal trauma complicated by major vessels injuries.