RESUMEN
This article deals with the bibliographic information relating to the Saratov period of life of Alexander Nikolayevich Bakulev, his scientific and practical activity at the Department of Hospital Surgery of the Saratov Medical University under the leadership of the Department's founder, Sergey Ivanovich Spasokukotsky having exerted the key influence on the formation of A.N. Bakulev as a surgeon and scientist.
RESUMEN
The authors examined the effect of the presence of undifferentiated connective tissue dysplasia (UCTD) on the clinical course of lower-limb varicose veins (LLVV) and acute varicothrombophlebitis (AVTP) in patients after the Troyanov-Trendelenburg operation. We carried out a prospective comparative study of the remote results during three years after the Troyanov-Trendelenburg operation in a total of 132 patients suffering from AVTP. The Study Group included 67 patients found to have more than four phenotypic traits of UCTD, thus suggesting the presence of UCTD. The Comparison Group consisted of 65 patients with no signs of UCTD. During three-year follow up, relapses of AVTP were diagnosed in 22 (32.8%) patients of the Study Group and in 5 (7.7%) patients of the Comparison Group (p<0.01). In four (6.0%) patients with UCTD, the thrombus propagated to the perforating veins of the crus, new danger of pulmonary embolism arose, and emergency phlebectomy was required. Thrombosis of the femoral vein was revealed in eight (11.9%) patients of the Study Group, and being free-floating in two (3.0%) of them, it was the cause of pulmonary embolism. They were subjected to plication of the external iliac vein. No thromboses of deep veins were revealed in the Comparison Group patients. Phlebectomy was performed in 57 (85.1%) patients of the Study Group and in 14 (21.5%) patients of the Comparison Group (p<0.01) due to remaining vertical and horizontal pathological venous reflux. Fifty-one (78.5%) patients of the Comparison Group six months after the Troyanov-Trendelenburg operation were found to have spontaneous restoration of the functional competence of the valvular apparatus of the perforating veins with elimination of the horizontal venous reflux, which predetermined regression of clinical manifestations of varicose veins, with no phlebectomy required. A conclusion drawn is that the clinical course of LLVV on the background of UCTD after the Troyanov-Trendelenburg operation is distinguished by predisposition to progression of chronic venous insufficiency and is characterised by a relapsing pattern of AVTP. Therefore, surgical policy, as well as medicamentous treatment after disconnection of the saphenofemoral junction in patients with AVTP should be decided upon with due regard for the phenotypic signs characterising UCTD.
Asunto(s)
Efectos Adversos a Largo Plazo , Extremidad Inferior/irrigación sanguínea , Complicaciones Posoperatorias , Embolia Pulmonar , Tromboflebitis , Várices , Procedimientos Quirúrgicos Vasculares , Enfermedad Aguda , Adulto , Progresión de la Enfermedad , Femenino , Humanos , Efectos Adversos a Largo Plazo/diagnóstico , Efectos Adversos a Largo Plazo/etiología , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiología , Embolia Pulmonar/prevención & control , Recurrencia , Federación de Rusia , Tromboflebitis/diagnóstico , Tromboflebitis/etiología , Tromboflebitis/fisiopatología , Tromboflebitis/cirugía , Ultrasonografía Doppler Dúplex/métodos , Várices/complicaciones , Várices/patología , Procedimientos Quirúrgicos Vasculares/efectos adversos , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
PURPOSE: To determine interrelationship between lower limb varicosity, the clinical grade of non-differentiated dysplasia of the connective tissue and atrial fibrillation in patients with coronary artery disease (CAD). MATERIAL AND METHODS: Altogether 156 coronary patients were examined. Persistent atrial fibrillation was present in 58 and chronic in 38 patients. The reference group comprised 60 patients without evident rhythm disorders in persons suffering from CAD. Markers of connective tissue dysplasia (<
Asunto(s)
Fibrilación Atrial/complicaciones , Enfermedades del Tejido Conjuntivo/complicaciones , Enfermedad Coronaria/complicaciones , Várices/complicaciones , Anciano , Fibrilación Atrial/epidemiología , Fibrilación Atrial/fisiopatología , Enfermedades del Tejido Conjuntivo/diagnóstico , Enfermedades del Tejido Conjuntivo/epidemiología , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/fisiopatología , Electrocardiografía Ambulatoria , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pronóstico , Índice de Severidad de la Enfermedad , Várices/diagnóstico , Várices/epidemiologíaRESUMEN
The work analyses the results of the multimodality treatment of 80 patients among whom 20 suffered from endarteritis obliterans and 60 from atherosclerosis obliterans of the lower limb vessels. In the process of complex treatment intravascular laser irradiation of blood (ILIB) was carried out by introducing the light guide into a peripheral vein. In 31 (73.8%) patients with decompensated circulatory disorders in the limbs, a course of ILIB produced a good clinical effect. A positive effect was encountered in 35 (92.1%) of patients with subcompensated circulatory disorders in the lower limbs. The clinical efficacy of ILIB is due to normalization of blood coagulative properties, increase of the fibrinolytic potential, improvement of hemorheology, and normalization of the lipoprotein ratio.