RESUMO
The prognostication method for the hemorrhage recurrence, permitting to estimate the risk of its occurrence and to prescribe an adequate antirecurrence treatment, was proposed. Among numerous predictors of recurrence the most significant clinical, endoscopic and laboratory factors were selected to raise the prognostication precision. Depending on therisk degree of a recurrent hemorrhage, different methods of treatment were prescribed to the patients. The proposed method was applied in 112 patients, suffering ulcer gastroduodenal hemorrhage. The hemorrhage recurrence have had occurred in 45 (43.3%) of them, in 5 (4.46%)--operative intervention was conducted, using organpreserving methods. General lethality have had constituted 0.89%, postoperative one in a control group--7.14%, and in the main all the patients were alive. The method proposed permits with a high precision to prognosticate and to determine effective tactics of treatment. Taking into account the additional factors of risk raises the prognosis precision and permits to prescribe antihelicobacter therapy and the proton pump inhibirors in a rational dosage soundly.
Assuntos
Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/prevenção & controle , Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica/cirurgia , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Humanos , Úlcera Péptica/tratamento farmacológico , Úlcera Péptica Hemorrágica/tratamento farmacológico , Prognóstico , Inibidores da Bomba de Prótons/uso terapêutico , Recidiva , Projetos de Pesquisa , Estudos Retrospectivos , Fatores de RiscoRESUMO
Comparative analysis of medical documents, concerning 1055 patients, aged 18-92 yrs old, operated for an acute surgical diseases of abdominal organs in 2007-2009 yrs, was performed. Preoperative antibioticotherapy was performed in all the patients, in 877 of them ceftazidim (ceftadim) was administered as the main antibacterial preparation and in 178--other antibacterial preparations. Application of ceftadim, as a basic preparation in antibioticotherapy, had permitted to lower the purulent-septic complications rate by 61% and to reduce the stationary treatment duration of the patients.
Assuntos
Antibacterianos/uso terapêutico , Ceftazidima/uso terapêutico , Infecção da Ferida Cirúrgica/tratamento farmacológico , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Ceftazidima/administração & dosagem , Humanos , Prontuários Médicos , Pessoa de Meia-Idade , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Resultado do Tratamento , Adulto JovemRESUMO
Under conditions of acute experiment with the use of sodium nitroprusside on 32 mongrel dogs, it was established that decrease in the mean systemic arterial pressure (MSAP) by 25.5% didn't lead to statistically significant decrease in the renal arterial pressure. At the same time, the maximum hepatic arterial pressure decreased by 25.2%, the minimal--by 13%. Decrease in the pulse hepatic arterial pressure forestalls that in the renal arterial pressure in deepening of hypotension. Pulse hepatic and renal arterial pressure disappeared in MSAP equal to (4.41 +/- 0.05) kPa, or (33.1 +/- 0.4) mm of Hg.
