[APPLICATION OF VACUUM-THERAPY IN COMPLEX OF TREATMENT OF THE LOWER EXTREMITIES CHRONIC WOUNDS].

Experience of treatment of chronic wounds in 11 patients in 2014 ­ 2016 yrs was analyzed. The impact of negative pressure, using domestically manufactured apparatus «ÐGАТ- Dnepr¼, in complex of treatment as a local therapy, was applied. Vacuum-therapy was conducted preoperatively and postoperatively together with autodermoplasty. The injection material for the skin regeneration "lacerta" was applied subcutaneously intraoperatively. The Ialuset-cream bandages were used in 10 - 12 days postoperatively during 2-3 weeks. Еfficacy of vacuum-therapy was estimated, basing on analysis of the wound process course dynamics, clinic-laboratory criteria, terms of the wound defect complete closure. The patients' stationary treatment duration have constituted 38.3 days at average. Complex treatment of chronic wounds have had guaranteed complete healing of the wound defect in 7 (63%) patients in terms up to 1 - 5 weeks, and in 3 (26%) - 6 weeks.

[THE TREATMENT TACTICS IN GASTROINTESTINAL ULCER HEMORRHAGE].

Experience of the patients treatment, suffering gastrointestinal ulcer hemorrhage, in Municipal Centre, dealing with such cases, was summarized. There was established, that conduction of endoscopic monitoring is indicated in all patients, suffering gastrointestinal ulcer hemorrhage for early diagnosis of the hemorrhage recurrence signs and conduction of prophylactic measures. Introduction of local endoscopic hemostasis, еndoscopic monitoring in complex of conservative therapy have permitted to reduce the operative interventions conduction rate in 2,5 times.

[Mucosal changes in the periulcer zone and endocrine system in patients with gastroduodenal ulcer, complicated by hemorrhage].

Examination of patients, suffering gastroduodenal ulcer, complicated by hemorrhage, was conducted, using clinical, microbiological, immunohistochemical methods and chromatomassspectrography. Enhanced activity of inducible NO-synthase, contamination of periulcer zone with microorganisms Klebsiella pneumoniae, Streptococcus beta-haemoliticus, enhancement of contents of catecholamines and serotonin in the blood serum were revealed. These changes are most expressed in severe blood loss, unstable local endoscopic hemostasis, high risk of a recurrent hemorrhage occurrence. The data obtained permit to prognosticate severity of a pathologic process course and to improve the treatment programe.

[Peculiarities of treatment of ulcerative gastrointestinal hemorrhage in pregnant women].

The occurrence rate of gastrointestinal hemorrhage (GIH) of nonvaricosal genesis in pregnant women was analyzed. The risk of complications occurrence in the pregnancy course while performing local endoscopic hemostasis and prophylaxis of the hemorrhage recurrence occurrence was established. Application of elaborated treatment method for GIH of nonvaricosic genesis in pregnant women have promoted reduction of the severe complications rate in the pregnancy course, applying elimination of the vasoconstrictor and uterotonic effects of adrenalin, reduction of esophagogastroduodenoscopy duration. While application of this procedure in pregnant women of a main group operative cessation of GIH was not applied. In a comparison group a hemostasis, using operative way, was done in 2 (13.3%) women patients with subsequent occurrence of preeclampsy, what resulted in antenathal fetal death.

[Prognostication of gastroduodenal ulcer course complicated by hemorrhage].

Dynamics of the blood serum level of serotonin in the patients, suffering gastroduodenal ulcer, Complicated by hemorrhage, was analyzed. The highest level of serotonin was observed in gastric ulcer, complicated by hemorrhage. These changes correlate with the blood loss severity enhancement, the achievement of a nonstable state of endoscopic hemostasis, high activity of inducible NO-synthase (iNOS) of periulcerative mucosa. The obtained data analysis permits to prognosticate the pathological process course and to improve the program of treatment.

[Dynamics of catecholamines in serum of patients with gastroduodenal ulcers complicated by hemorrhage].

The dynamics of the catecholamines content in the blood serum of the patients, suffering gastroduodenal ulcer, complicated by hemorrhage, was analyzed. The biggest raising of the investigated index level was observed in patients while presence of gastric cancer, complicated by hemorrhage. These changes correlate with the blood loss severity enhancement, the state of unstable endoscopic hemostasis, high activity of the inducible NO-synthase of the peri-ulceral zone mucosa. The data obtained permit to prognosticate the pathological process and to improve the treatment program.

[Treatment strategy for ulcerative gastrointestinal bleeding from the upper gastrointestinal tract].

The deep statistical analysis of patients treatment with the ulcerous gastroduodenal bleeding set 2 years works of Center of the gastroduodenal bleeding of Dnepropetrovsk is conducted. It is exposed, that wide application of methods of endoscopic haemostasis and endoscopic monitoring allowed substantially to reduce the amount of operations at this category of patients and improve the results.

[Clinical, morphological, and microbiological characteristics of the Mallory-Weiss syndrome].

The profound clinico-morphological and immunological analysis was performed in patients suffering Mallory-Weiss syndrome (MWS). Doing endoscopic and morphological investigations the most dangerous foci of the affection were revealed and there links with the disease course severity and the recurrences rate established. The signs of unstable haemostasis were revealed according to the endoscopic investigation data. Morphological changes of gastric mucosa in patients suffering MWS are similar to those in duodenal ulcer disease. Polymorphism of mucosal microorganisms with E. coli, Streptococcus beta-haemoliticus, Klebsiella pneumoniae, Candida albicans predominance, which severe the disease course and cause the haemorrhage recurrence, was characteristic for MWS in 85% of observations. These causing agents are sensitive to II-III generation cephalosporins and fluoroquinolons in 75% of observations. The complex of conservative treatment must include, besides restorational, untiulcer, antihelicobacter and antibacterial therapy.