[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.

[Short-term results of "large" amputations in patients with chronic lower limb arterial occlusions].

The results of examinations and treatment are presented for 238 patients with lower limb arterial occlusions after "large" amputation for critical limb ischemia. Arterial reconstructions and lumbar sympathectomy, adequate choice of amputation level based on objective parameters of macro- and microcirculation, epidural anesthesia, prophylaxis of early thromboembolism and cardiovascular complications are measures which can improve results of "large" amputations in patients with lower limb arterial occlusions.