RESUMO
Account of such indices of blood rheology as viscosity, erythrocyte aggregation coefficient, indices of lipid peroxidation and endogenous intoxication allowed the authors to fulfill therapeutic treatment of patients with hemorrhage of portal genesis more efficiently.
Assuntos
Viscosidade Sanguínea/fisiologia , Agregação Eritrocítica/fisiologia , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/sangue , Adulto , Idoso , Feminino , Hemorragia Gastrointestinal/complicações , Hemorreologia , Humanos , Peroxidação de Lipídeos/fisiologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
Based on a comparative analysis of results of the surgical treatment of bleedings from varicose veins of the liver and stomach, the authors recommend differential decision for the variants of surgical interventions at different periods from the moment of the appearance of bleeding and depending on the severity of impairments of the liver functions.
Assuntos
Hipertensão Portal/complicações , Fígado/irrigação sanguínea , Fígado/fisiopatologia , Escleroterapia/métodos , Gastropatias/fisiopatologia , Gastropatias/cirurgia , Varizes , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cárdia/irrigação sanguínea , Cárdia/fisiopatologia , Feminino , Hemodinâmica/fisiologia , Humanos , Masculino , Microcirculação/fisiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Varizes/complicações , Varizes/fisiopatologia , Varizes/terapiaRESUMO
The role of hemorheologic disorders in the pathogenesis of portal hypertension in shown. Rheologic disorders are characteristic of both intrahepatic and extrahepatic forms of portal hypertension. It was found that the rate of hemolysis, disorders of the lipid composition and conformation of red cell proteins is reduced in cirrhosis of the liver complicated by portal hypertension. Changes in the portal system microvessels are attended by microcirculatory disorders which are aggravated by changes in the properties of the cell membrane caused by disorders of the blood physico-chemical properties. Purposeful correction of the hemorheologic disorders has a positive effect on the rheologic parameters only in 3-4 weeks. Postoperative complications occur most frequently on the 10th-14th day. A recurrence of acute hepatic insufficiency is also noted at this time in most patients after drainage of the thoracic duct in aggravation of blood rheology. Direct changes of blood rheology in the portal system were revealed, which is a manifestation of the continuously active mechanism of the syndrome which may cause thromboses and massive hemorrhage.
Assuntos
Hipertensão Portal/fisiopatologia , Cirrose Hepática/fisiopatologia , Sistema Porta/fisiopatologia , Adulto , Eritrócitos/fisiologia , Feminino , Hemodinâmica , Hemólise , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/cirurgia , Cirrose Hepática/complicações , Cirrose Hepática/cirurgia , Complicações Pós-Operatórias , Recidiva , Reologia , Fatores de TempoRESUMO
A study of 132 patients, aged 15 to 40 years, with bilateral scalenus syndrome, accompanied by vertebrobasilar insufficiency, is reported. The diagnostic value was assessed on the basis of 164 angiograms and 408 blood rheologic parameters. Selective arteriography, conducted simultaneously with the compression test and endovascular pressure gradient measurement, yields the most exhaustive and reliable data on the topical cause of the circulatory disturbance within the subclavian artery and its branches. The scalenus syndrome is an important etiologic factor of vertebrobasilar insufficiency. Intermittent flow through the vertebral artery results from ostium compression, spasm or increased flow in one of the vertebral arteries that may be due to an abnormal flexure, local pressure rise or high arcuation of the subclavian arterial segments I and II. Regional disorders of blood rheologic properties are also in evidence. Surgical treatment produces stable good results.