[Efferent methods and hyperbaric oxygen therapy for great vessels injuries of extremities]. / Rezul'taty primeneniia éfferentnykh metodov i giperbaricheskoi oksigenatsii pri travmakh krupnykh arterii konechnostei.

AIM: To evaluate an efficacy of efferent therapy of great vessels injuries of extremities and acute limb ischemia. MATERIAL AND METHODS: There were 197 patients (main group -107, control group - 90 patients) with great vessels injuries of extremities and acute limb ischemia. The patients of the main group underwent plasmapheresis, ultraviolet irradiation of blood (UVIB) and hyperbaric oxygen (HBO) therapy. Efferent methods were used depending on the severity of acute ischemia, intoxication and infection (intoxication - plasmapheresis, ischemia - plasmapheresis + HBO, infections - UVIB, their combination - plasmapheresis + UVIB + HBO). RESULTS: Limb amputation and necrectomy were required only in 2 (1.96%) and 3 (2.8%) patients of the main group, mortality - 0.94% (n=1). In the control group these values were 16 (17.8%), 10 (11.1%) and 7 (7.8%), respectively. CONCLUSION: Efferent methods are effective in patients with traumatic vascular injuries and acute limb ischemia regarding improvement of clinical outcomes and 2-fold reduction of hospital-stay, less number of amputations and decreased mortality rate.

[The results of combined surgical treatment of thromboangiitis obliterans and critical lower limb ischemia using prolonged epidural analgesia and autohemotherapy with ozone]. / Rezul'taty kombinirovannogo khirurgicheskogo lecheniya bol'nykh obliteriruyushchim trombangiitom i kriticheskoi ishemiei nizhnikh konechnostei.

AIM: to evaluate the results of combined treatment of thromboangiitis obliterans with severe lower limb ischemia using prolonged epidural anaesthesia and autohemotherapy with ozone. MATERIAL AND METHODS: It was analyzed treatment of 125 patients with thromboangiitis obliterans and severe lower limb ischemia. Patients were divided into 2 groups. Control group consisted of 60 patients who underwent conventional perioperative therapy with anticoagulants, antiplatelet agents, dextrans, metabolic drugs, glucocorticoids, angioprotectors, narcotic and non-narcotic analgesics. Study group included 65 patients in whom prolonged epidural anaesthesia and autohemotherapy with ozone was applied additionally. RESULTS: In early postoperative period (up to 30 days) the incidence of secondary lower leg amputation was 10% and 1.5% in both groups respectively (p<0.05). Primary healing after limited foot amputation was achieved in 63.6% and 83.3% in control and stugy groups respectively (p<0.05). Ulcerative defect recovery was observed in 62.2% and 76.2% in both groups respectively (p<0.01). Satisfactory result of treatment was obtained in 61.7% and 80.0% of patients. CONCLUSION: Restoration of magistral and collateral blood flow combined with prolonged epidural anaesthesia and autohemotherapy with ozone improves surgical outcomes and rehabilitation of patients with thromboangiitis obliterans and severe lower limb ischemia.