RESUMO
Oscillating drop experiments with a drop profile analysis tensiometer provide the dilational elasticity and viscosity of surface layer. Model experiments for blood serum, composed of HSA and the non-ionic surfactant C(14)EO(8), are used to demonstrate the theoretical approach for calculating the visco-elasticity of mixed adsorption layers from the adsorption characteristics of the single components. Experiments with real serum samples taken from patients choledocholithiasis-based benign obstructive jaundice before and after re-canalisation of the biliary tract demonstrate that the visco-elasticity of the respective adsorption layers is very sensitive of the successful surgery.
Assuntos
Reologia/métodos , Albumina Sérica/química , Soro/química , Adulto , Procedimentos Cirúrgicos do Sistema Biliar , Coledocolitíase/complicações , Coledocolitíase/fisiopatologia , Etilenoglicóis/química , Feminino , Humanos , Icterícia Obstrutiva/etiologia , Icterícia Obstrutiva/fisiopatologia , Ligação Proteica , Propriedades de Superfície , Tensão Superficial , Tensoativos/químicaAssuntos
Colecistectomia Laparoscópica , Colecistite/cirurgia , Doença Aguda , Adulto , Idoso , Colecistectomia Laparoscópica/instrumentação , Colecistectomia Laparoscópica/métodos , Colecistite/radioterapia , Terapia Combinada , Feminino , Humanos , Terapia a Laser , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/prevenção & controle , Fatores de TempoRESUMO
Changes in certain indices for central hemodynamics in the early period after emergency operation were evaluated in 79 patients with helcoid gastroduodenal hemorrhage, the patients' age ranging between 18 to 80 years. At admission all patients demonstrated lowered cardiac and stroke output, cardiac and stroke indices, with the total peripheral vascular resistance being slightly increased. Operation aggravates disturbances in hemodynamics caused by loss of blood. Under the effect of corrective therapy, from day 3 to 5, indices for central hemodynamics tend to slowly return to normal as do those for hepatic bloodflow. The impairment of the function of the circulatory system appear to be greater in cases presenting with deficiency of globular volume of excess of 50%, whose compensatory potential is under too severe a strain. At discharge from the hospital, the percentage of those cases presenting with hypodynamic type circulation amounted to 67.3%, normodynamic having been 32.7%.
Assuntos
Úlcera Duodenal/complicações , Hemodinâmica , Úlcera Péptica Hemorrágica/fisiopatologia , Úlcera Gástrica/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Úlcera Duodenal/mortalidade , Úlcera Duodenal/fisiopatologia , Emergências , Humanos , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/mortalidade , Período Pós-Operatório , Úlcera Gástrica/mortalidade , Úlcera Gástrica/fisiopatologia , Fatores de TempoRESUMO
The results of treatment of 380 patients with the globular volume deficiency of 40% and more, operated in urgency for ulcer gastroduodenal bleeding. In 124 (32.6%) of them ulcer was localized in the stomach, in 224 (64.2%)--in pyloroduodenal region, in 12 (3.2%)--the combined ulcers were revealed. Cause of the death was an acute cardiovascular insufficiency in 11.1% of patients, thromboembolia of the pulmonary artery--in 1.3%, bleeding ulcer or erosion--in 1.6%. Suture insufficiency of the duodenal stump and anastomoses occurred in 5.8%, pneumonia--in 12.6%, purulent complications--in 6.3%. The conduction of proposed surgical tactics permitted to lower the mortality after operations for persistent bleeding down to 12.5%, the prevalence of recurrent bleeding occurrence--to 12.5%. The prevalence of operations accomplishment in the patients with high risk of bleeding recurrence have increased up to 78.7%, radical intervention--to 70.7%. The authors make a conclusion about perspectivity of the proposed elaborated an active-rational therapeutical tactics in the patients with severe gastroduodenal bleeding.