[Hemostasis and lipid peroxidation in the therapy of brain concussion at exacerbation].

130 patients with brain concussion (BC) and 30 virtually healthy subjects, aged 16 to 50, were examined for the purpose of studying the influence exerted by different drugs affecting blood coagulation, fibrinolysis, lipid peroxidation (LPO) and antioxidant protection at exacerbation. Changes of hemostasis in BC were shown to be of the adaptation nature and to depend essentially on a conducted treatment. Normalized plasma components in the hemostasis system were registered in groups receiving cavinton. The drug, when used, reduced the LPO intensity and intensified the activity of dismutase superoxide on days 9-12 after trauma.

[Ways to decrease blood loss during total hip joint endoprosthesis]. / Puti umen'sheniia krovopoteri pri total'nom éndoprotezirovanii tazobedrennogo sustava.

Total replacement (endoprosthesis) of the hip joint was carried out in 93 patients aged 18-60 years. Sixteen operations were performed under prolonged epidural blockade, 66 under neuroleptanalgesia, and 16 under ataralgesia. A deficiency of circulating blood volume was detected in all patients before surgery. The lowest mean arterial pressure was recorded in the prolonged epidural block group, while in the neuroleptanalgesia and ataralgesia groups the mean arterial pressure was virtually the same. Isovolemic hemodilution in patients with preoperative deficit of circulating blood volume decreased blood loss during long traumatic operations. Prolonged epidural blockade in combination with isovolemic hemodilution and spontaneous respiration led to a notable (70%) decrease of the true blood loss in comparison with the traditional neuroleptanalgesia.

[The correction of the disseminated intravascular coagulation syndrome in the emergency surgery of gastrointestinal tract cancer]. / Korrektsiia sindroma disseminirovannogo vnutrisosudistogo svertyvaniia krovi v neotlozhnoi khirurgii raka zheludochno-kishechnogo trakta.

The authors estimate results of correction of the hemostasis system in surgical treatment of 63 patients with complicated carcinoma of the gastro-intestinal tract. It was found that purulent peritonitis, profuse hemorrhage and obturative obstruction facilitated the development of local and generalized DIC syndrome. Methods of correction of the hemostasis system, endogenous intoxication during preoperative preparing are described. Expedience of radical operations is stressed. Complex postoperative detoxication is recommended as well as measures for the restoration of activity of the vascular-thrombocytic hemostasis and prevention of thrombus formation.

[The intensive therapy of posthypoxic encephalopathy]. / Intensivnaia terapiia postgipoksicheskoi éntsefalopatii.

A complex of therapeutic measures including hyperbaric oxygenation combined with heparin and endolumbal injection of glucocorticoids, proteolysis inhibitors, was carried out in 49 patients aged 16 to 95 with posthypoxic encephalopathy caused by mechanical asphyxia (11 patients,) carbon monoxide (12 cases), narcotics (18 cases), and closed craniocerebral injury (8 patients). Lipid peroxidation, some parameters of homeostasis, electrolyte, acid-base, and gaseous composition of the blood and liquor were studied before and during treatment. Positive clinical results were attained in 88.6% cases. Multiple-modality treatment of this patient population led to normalization of the coagulation potential of the blood and of the content of fibrinogen, but did not appreciably affect the electrolyte balance, acid-base, and gaseous composition of the blood. The activity of superoxide dismutase normalized, but the concentration of malonic dialdehyde increased, with the levels of dienic conjugates and nonerythrocytic hemoglobin being unchanged; however, the metabolic acidosis in the liquor still persisted.

[The diagnosis and clinical assessment of the disseminated intravascular coagulation syndrome in complicated cancer of the gastrointestinal tract]. / Diagnostika i klinicheskaia otsenka sindroma disseminirovannogo vnutrisosudistogo svertyvaniia krovi pri oslozhnennom rake zheludochno-kishechnogo trakta.

Under study were the state of the hemostasis system, the level of endogenous intoxication and anti-infectional defense in 63 patients with complicated carcinoma of the gastro-intestinal tract (GIT). It was established that the patients had the syndrome of disseminated intravascular coagulation (DIC) of blood which at first was of local character. Acute complications of carcinoma of GIT, first of all purulent peritonitis and profuse gastro-intestinal bleedings, aggravate endotoxicosis and facilitate the development of the acute DIC syndrome. A conception of the development of the intoxicative DIC syndrome is presented and proposed are informative methods of the assessment of hemostasis in emergency surgery of carcinoma of the GIT.

[Effects of hyperoxia regimes on the state of lipid peroxidation and hemostasis in patients with lesions of the central nervous system]. / Vliianie rezhimov giperoksii na sostoianie perekisnogo okisleniia lipidov i gemostaz u bol'nykh s porazheniiami tsentral'noi nervnoi sistemy.

Lipid peroxidation and some parameters of hemostasis were studied during exposure to various hyperoxia schemes combined with heparin therapy before and after treatment in 124 patients aged 16 to 69 with CNS involvement which developed as a result of atherosclerosis and essential hypertension, 60 of whom presented with initial manifestations of cerebral circulation insufficiency (IMCCI), 33 with posthypoxic encephalopathies (PE), and 31 with ischemic stroke (IS). Hyperoxia mechanisms were differently directed in the studied groups of patients, this necessitating a differentiated approach to the choice of schemes of hyperbaric oxygenation. Use of a short course of hyperbaric oxygenation (up to 3 sessions at 1.2 to 1.25 atA) is recommended for patients with IMCCI and PE. For patients with IS in the acute period hyperbaric oxygenation at 1.4 atA is advisable combined with heparin therapy in doses of 150 to 300 U/kg b.w. a day.