RESUMEN
Results of examination of 46 patients, suffering obliterating atherosclerosis of the lower extremities arteries solely or in combination with diabetes mellitus (DM), were analyzed. The malleolar pressure index (MPI), regional systolic pressure (RSP), velocity of the volume blood flow (VVBF), rheographic index (RI), using test with nitroglycerine, postocclusion venous pressure (POVP) and intaosseous pressure (IOP) in tibiae were studied. The RI reduction, parallel to the arterial ischemia progression, was established. The test indices with nitroglycerine in patients with obliterating atherosclerosis have reduced step by step. With coexistent DM the efficacy of nitroglycerine was practically absent. POVP is upgraded in patients of all the groups and it have lowered step by step in a laying position of the patient, and while transition into standing position--it have upgraded progressively with a progress of arterial ischemia. IOP have upgraded significantly in isolated obliterating atherosclerosis in ischemia stage 3a and have lowered--in stage 3b. In coexistent DM IOP is upgraded in ischemia stage 3b also.
Asunto(s)
Arteriosclerosis Obliterante/fisiopatología , Diabetes Mellitus/fisiopatología , Isquemia/fisiopatología , Extremidad Inferior/fisiopatología , Arterias Tibiales/fisiopatología , Arteriosclerosis Obliterante/complicaciones , Arteriosclerosis Obliterante/patología , Velocidad del Flujo Sanguíneo , Presión Sanguínea , Complicaciones de la Diabetes , Diabetes Mellitus/patología , Humanos , Isquemia/complicaciones , Isquemia/patología , Extremidad Inferior/irrigación sanguínea , Extremidad Inferior/patología , Pletismografía de Impedancia , Presión , Índice de Severidad de la Enfermedad , Tibia/irrigación sanguínea , Tibia/patología , Arterias Tibiales/patologíaAsunto(s)
Neoplasias del Colon/prevención & control , Colostomía/métodos , Ileus/cirugía , Intestino Grueso/cirugía , Enfermedad Aguda , Neoplasias del Colon/etiología , Neoplasias del Colon/patología , Humanos , Ileus/complicaciones , Ileus/patología , Intestino Grueso/patología , Resultado del TratamientoRESUMEN
Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times.
Asunto(s)
Colostomía/métodos , Obstrucción Intestinal/cirugía , Intestino Grueso/cirugía , Complicaciones Posoperatorias/prevención & control , Enfermedad Aguda , Adulto , Anciano , Vendajes/economía , Colostomía/instrumentación , Femenino , Humanos , Obstrucción Intestinal/mortalidad , Obstrucción Intestinal/patología , Intestino Grueso/patología , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Análisis de SupervivenciaRESUMEN
The results of treatment were analyzed in 47 patients, suffering operable cancer of left half of large bowel, complicated by an acute obturation ileus of the large bowel (AOILB), in whom radical obstructive operation of the Hartmann type was performed. In 26 patients (the 1-st group) a typical obstructive operation of Hartmann type was accomplished, and in 21 (2-nd group)--a radical obstructive operation in accordance to the method proposed. In a 1-st group postoperative complications have occurred in 7 (26.9%) patients, duration of stay in stationary was 19 days on average; in the 2-nd group the complications were observed in 2 (9.5%) patients. Duration of treatment in stationary was 13 days. Thus, application of the method of surgical treatment of the AOILB proposed have permitted to reduce postoperative morbidity rate in 2.8 times, the lethality--in 2.4 times, duration of a stationary treatment--in 1.4 times, necessity in postoperative wound dressing procedures and expenditure on dressing material--in 10 times.