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1.
Khirurgiia (Mosk) ; (1): 40-45, 2020.
Artigo em Russo | MEDLINE | ID: mdl-31994498

RESUMO

OBJECTIVE: To improve the results of treatment of patients undergoing laparotomy by using of a new method of aponeurosis suturing after laparotomy. MATERIAL AND METHODS: Training process for a new method of aponeurosis suturing after laparotomy was organized on the patented medical simulator for learning the technique of laparotomy closure. The method was introduced into surgical practice later. The study involved 130 patients who underwent emergency abdominal surgery through median laparotomy. The main group consisted of 70 patients (laparotomy closure using the proposed method (RF patent No.2644846 dated 02/14/18). Interrupted sutures were applied for aponeurosis suturing in the control group. RESULTS: Duration of laparotomy closure was similar in both groups. Postoperative ventral hernias in 1 year after surgery occurred in 5 (8%) patients of the main group and in 11 (18%) patients of the control group. CONCLUSION: The proposed method of aponeurosis suturing after laparotomy is mastered by students and serves as effective method for prevention of postoperative ventral hernias and eventration.


Assuntos
Técnicas de Fechamento de Ferimentos Abdominais/educação , Aponeurose/cirurgia , Hérnia Ventral/prevenção & controle , Hérnia Incisional/prevenção & controle , Laparotomia/efeitos adversos , Técnicas de Sutura/educação , Fáscia , Hérnia Ventral/etiologia , Humanos , Hérnia Incisional/etiologia , Laparotomia/educação , Modelos Anatômicos
2.
Khirurgiia (Mosk) ; (4): 77-83, 2018.
Artigo em Russo | MEDLINE | ID: mdl-29697689

RESUMO

The purpose of this study was to determine the effect on the effectiveness of the correction of enteric insufficiency syndrome in patients with urgent surgical pathology included in the scheme of complex therapy Remaxol. The results of complex therapy of 227 patients (98 people with common peritonitis and 129 patients with acute intestinal obstruction) were analyzed. 128 patients of the main group in the postoperative period were included in the therapy scheme Remaxol: intravenously drip in a daily dose of 400 ml at a rate of 40 drops per minute, a course of -5 days. Patients of the control group (99 people) received standard treatment. The study is devoted to the role of postoperative hepatoprotective therapy in the treatment of patients with urgent surgical pathology. The main attention is paid to the hepatoenteric link of the pathogenesis of polyorganism insufficiency. This approach gives hope for a reduction in the risk of abdominal sepsis and a reduction in mortality among patients with acute abdominal pathology. The study found that in patients with acute abdominal pathology, an increase in the severity of enteric insufficiency syndrome due to toxic aggression and bacterial translocation can lead to hepatic dysfunction. Consequently, the implementation of hepatoprotective therapy is a pathogenetic link in the complex treatment of urgent surgical patients. The obtained results allowed to draw a number of conclusions. In particular, it has been established that the use of hepatoprotective therapy in the complex medical treatment of patients with acute abdominal pathology makes it possible to stop hepatorenal syndrome by the 5th day, and the syndrome of enteric insufficiency by the 7th day. Earlier relief of hepatic dysfunction and enteral insufficiency syndrome due to hepatoprotective therapy allowed to reduce the incidence of infectious complications to 9.7%, to reduce the lethality to 9.4% and to shorten hospitalization from 17.29 to 1.734 to 12.14±1.385 bed/day.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Insuficiência Hepática , Obstrução Intestinal , Intestino Delgado , Peritonite , Succinatos/administração & dosagem , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Monitoramento de Medicamentos , Feminino , Insuficiência Hepática/etiologia , Insuficiência Hepática/prevenção & controle , Humanos , Obstrução Intestinal/complicações , Obstrução Intestinal/cirurgia , Intestino Delgado/fisiopatologia , Intestino Delgado/cirurgia , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/prevenção & controle , Peritonite/etiologia , Peritonite/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/prevenção & controle , Substâncias Protetoras/administração & dosagem , Sepse/etiologia , Sepse/prevenção & controle , Resultado do Tratamento
3.
Phys Rev E ; 95(6-1): 063207, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28709289

RESUMO

A self-consistent model of plasma polarization around an isolated micron-sized dust particle under the action of an external electric field is presented. It is shown that the quasineutral condition is fulfilled and the formed volume charge totally screens the dust particle. The ion focusing and wake formation behind the dust particle are demonstrated for different ion mean free paths and the external electric fields. It is obtained that at low values of the external electric field the trapped ions play the main role in the screening of the dust particle charge. For high external electric fields, the density of trapped ions decreases and the dust particle is screened mainly by the free ions.

4.
Khirurgiia (Mosk) ; (6): 37-40, 2017.
Artigo em Russo | MEDLINE | ID: mdl-28638012

RESUMO

AIM: To assess experimentally different laparotomy closure techniques. MATERIAL AND METHODS: Experimental research on laboratory animals was performed. Laboratory animals underwent laparotomy followed by aponeurosis suturing by using of interrupted, continuous suture and continuous suture with an arrangement of stitches at different levels. Tensometric and histological examination of tissue specimens together with sutures was made in 7, 14, 60 days after surgery. RESULTS: Correlation of laparotomy closure technique with values of durability, elasticity and wound process course was obtained. CONCLUSION: Continuous suture after laparotomy promotes the formation of more mature granulation tissue and more solid scar with low elasticity compared with interrupted sutures.


Assuntos
Hérnia Ventral/prevenção & controle , Laparotomia/efeitos adversos , Deiscência da Ferida Operatória , Técnicas de Sutura , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Animais , Modelos Animais de Doenças , Tecido de Granulação/patologia , Hérnia Ventral/etiologia , Laparotomia/métodos , Ratos , Deiscência da Ferida Operatória/patologia , Deiscência da Ferida Operatória/prevenção & controle , Técnicas de Sutura/efeitos adversos , Técnicas de Sutura/classificação , Técnicas de Fechamento de Ferimentos
5.
Antibiot Khimioter ; 61(5-6): 21-24, 2016.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-29537737

RESUMO

Reliable inhibition of an infectious agent in the wound is an integral part of the therapeutic measures for the diabetic foot syndrome. Because of low immunity in patients with diabetes the use of antibiotics should be based not only on the'systemic but also local signs of the infection. Unfortunately, the antibiotic therapy does not always provide adequate inhibition of the pathogens. Investigation of the microbial landscape of the wound surface and susceptibility of the pathogens to antibiotics in patients with the diabetic foot syndrome showed that the main pathogens were Staphylococcus aureus, Enterococcus faecalis, Enterobacter cloacae and the Acinetobacter baumannii complex. A detailed analysis of the microbiological tests in a particular -department allows to identify the, most significant pathogens, that makes it possible to assign an earlier rational empirical antibiotic therapy for such pathology.

6.
Artigo em Inglês | MEDLINE | ID: mdl-26382534

RESUMO

Experimental investigations of dusty plasma parameters of a dc glow discharge were performed in a vertically oriented discharge tube. Under certain conditions, dust-free regions (voids) were formed in the center of the dust particle clouds that levitated in the strong electric field of a stratified positive column. A model for radial distribution of dusty plasma parameters of a dc glow discharge in inert gases was developed. The behavior of void formation was investigated for different discharge conditions (type of gas, discharge pressure, and discharge current) and dust particle parameters (particle radii and particle total number). It was shown that it is the ion drag force radial component that leads to the formation of voids. Both experimental and calculated results show that the higher the discharge current the wider dust-free region (void). The calculations also show that more pronounced voids are formed for dust particles with larger radii and under lower gas pressures.

7.
Artigo em Inglês | MEDLINE | ID: mdl-23410440

RESUMO

A self-consistent nonlocal model of the positive column of a dc glow discharge with dust particles is presented. Radial distributions of plasma parameters and the dust component in an axially homogeneous glow discharge are considered. The model is based on the solution of a nonlocal Boltzmann equation for the electron energy distribution function, drift-diffusion equations for ions, and the Poisson equation for a self-consistent electric field. The radial distribution of dust particle density in a dust cloud was fixed as a given steplike function or was chosen according to an equilibrium Boltzmann distribution. The balance of electron and ion production in argon ionization by an electron impact and their losses on the dust particle surface and on the discharge tube walls is taken into account. The interrelation of discharge plasma and the dust cloud is studied in a self-consistent way, and the radial distributions of the discharge plasma and dust particle parameters are obtained. It is shown that the influence of the dust cloud on the discharge plasma has a nonlocal behavior, e.g., density and charge distributions in the dust cloud substantially depend on the plasma parameters outside the dust cloud. As a result of a self-consistent evolution of plasma parameters to equilibrium steady-state conditions, ionization and recombination rates become equal to each other, electron and ion radial fluxes become equal to zero, and the radial component of electric field is expelled from the dust cloud.


Assuntos
Algoritmos , Modelos Químicos , Gases em Plasma/química , Reologia/métodos , Simulação por Computador , Campos Eletromagnéticos , Gases em Plasma/efeitos da radiação
8.
Vestn Khir Im I I Grek ; 169(2): 74-7, 2010.
Artigo em Russo | MEDLINE | ID: mdl-20552796

RESUMO

The article describes a non-typical access to treatment of gigantic incarcerated inguinal hernias. Preperitoneal suprainguinal access allows solution of the main task of operative aid in this pathology: inspection of the strangulated organs, safe dissection of the incarcerating ring and prosthesis of the anterior abdominal wall. This method in many aspects is comparable with traditional methods of hernioplasty, but the postoperative quality of life is much better.


Assuntos
Parede Abdominal/cirurgia , Hérnia Inguinal/cirurgia , Implantação de Prótese/métodos , Telas Cirúrgicas , Idoso , Humanos , Masculino , Desenho de Prótese , Qualidade de Vida , Resultado do Tratamento
9.
Phys Rev E Stat Nonlin Soft Matter Phys ; 81(1 Pt 2): 016402, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20365480

RESUMO

A self-consistent kinetic model of a low-pressure dc glow discharge with dust particles based on Boltzmann equation for the electron energy distribution function is presented. The ions and electrons production in ionizing processes as well as their recombination on the dust-particle surface and on the discharge tube wall were taken into account. The influence of dust-particle concentration N(d) on gas discharge and dust particles parameters was investigated. It is shown that the increase of N(d) leads to the increase of an averaged electric field and ion density, and to the decrease of a dust-particle charge and electron density in the dusty cloud. The results were obtained in a wide region of different discharge and dusty plasma parameters: dust particles density 10(2)-10(8) cm(-3), discharge current density 10(-1)-10(1) mA/cm(2), and dust particles radius 1, 2, and 5 microm. The scaling laws for dust-particle surface potential and electric filed dependencies on dust-particle density, particle radius and discharge currents were revealed. It is shown that the absorption of electrons and ions on the dust particles surface does not lead to the electron energy distribution function depletion due to a self-consistent adjustment of dust particles and discharge parameters.

10.
Phys Rev E Stat Nonlin Soft Matter Phys ; 79(3 Pt 2): 036404, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19392061

RESUMO

Dust-particles charging in a low-pressure glow discharge was investigated theoretically. The dust-particle charge was found on the basis of a developed self-consistent model taking into account the nonequilibrium character of electron distribution function and the formation of an ionic coat composed of bound or trapped ions around the dust particle. The dust-particle charge, the radial distributions of electron density, free and trapped ions densities, and the distribution of electrostatic potential were found. It was shown that the non-Maxwellian electron distribution function and collisional flux of trapped ions both reduce the dust-particle charge in comparison with that received with the help of the conventional orbital motion limited (OML) model. However, in rare collisional regimes in plasma when the collisional flux is negligible, the formation of ionic coat around a particle leads to a shielding of the proper charge of a dust particle. In low-pressure experiments, it is only possible to detect the effective charge of a dust particle that is equal to the difference between the proper charge of the particle and the charge of trapped ions. The calculated effective dust particle charge is in fairly good agreement with the experimental measurements of dust-particle charge dependence on gas pressure.

11.
Vestn Khir Im I I Grek ; 165(2): 48-52, 2006.
Artigo em Russo | MEDLINE | ID: mdl-16752640

RESUMO

The authors describe two methods of suturing injured finger tendons and requirements to suture material. A polyamide monofilament thread with a conventional number 3/0 used by the authors for a removable suture of the tendon is the suture material of choice. For a buried suture it is expedient to use absorbable threads which begin degrading within three weeks after operation. The developed by the authors loop-shaped removable and buried sutures are strong, atraumatic and simple for fulfillment.


Assuntos
Traumatismos dos Dedos/cirurgia , Técnicas de Sutura/instrumentação , Suturas , Traumatismos dos Tendões/cirurgia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
13.
Anesteziol Reanimatol ; (2): 48-51, 2001.
Artigo em Russo | MEDLINE | ID: mdl-11494902

RESUMO

A new method for lymph detoxication in patients with pyoresorptive endotoxicosis is proposed. The method is based on electrochemical oxidation of the lymph, is simple and cheap. After 4-h exposure of the lymph with 0.04% sodium hypochlorite the concentration of the main toxic metabolites appreciably decreased, while the levels of total protein and leukocytes changed negligibly. Electrochemical detoxication of the lymph was used in the treatment of 13 patients with pyoresorptive endotoxicosis and led to improvement of the clinical status and rapid decrease in the levels of the major toxic metabolites, which was particularly expressed 3 days after the treatment. No negative effects were observed. Hence, electrochemical detoxication of the lymph appreciably improved the results of treatment of patients with cholestatic endotoxicosis.


Assuntos
Eletroquímica , Endotoxinas , Linfa , Proteínas Sanguíneas/metabolismo , Colestase/terapia , Desinfetantes/administração & dosagem , Desinfetantes/farmacologia , Desinfetantes/uso terapêutico , Humanos , Linfa/citologia , Linfa/efeitos dos fármacos , Contagem de Linfócitos , Oxirredução , Hipoclorito de Sódio/administração & dosagem , Hipoclorito de Sódio/farmacologia , Hipoclorito de Sódio/uso terapêutico , Desintoxicação por Sorção , Supuração , Fatores de Tempo
14.
Vestn Khir Im I I Grek ; 158(6): 76-8, 1999.
Artigo em Russo | MEDLINE | ID: mdl-10709277

RESUMO

A method is proposed for lymph detoxication in patients with cholestatic endotoxicosis by indirect electrochemical oxidation. The method is simple and cheap. After the treatment of the toxic lymph with the solution of sodium chloride during 4 hours the concentration of main toxic metabolites in it was substantially decreased while the total protein content was practically not changed. Under study were the results of using electrochemical lymph detoxication in 11 patients with cholestatic endotoxicosis which was followed by better condition of the patients and by faster dynamics of lowering the level of the main toxic metabolites.


Assuntos
Colestase/terapia , Endotoxemia/terapia , Linfa/efeitos dos fármacos , Desintoxicação por Sorção/métodos , Adulto , Idoso , Colestase/sangue , Eletroquímica , Endotoxemia/sangue , Humanos , Pessoa de Meia-Idade , Oxidantes/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Desintoxicação por Sorção/estatística & dados numéricos , Fatores de Tempo
15.
Khirurgiia (Mosk) ; (8): 36-9, 1998.
Artigo em Russo | MEDLINE | ID: mdl-9753936

RESUMO

The aim of the study is the development of integral methods for early diagnosis and treatment of systemic pathobiochemical disturbances in patients with diabetes mellitus under conditions of acute surgical endotoxicosis as well as optimisation of surgical policy and drug pathogenetic correction. Blood lipids peroxidation (malonic dyaldehyde content in NADF and ascorbate-dependent systems, intermolecular sewings in erythrocytes membranes) and central hemodynamic parameters. The study was carried out in 199 patients with acute surgical diseases accompanied with diabetes mellitus. Peculiarities of the course of the disease were revealed in dependence of the form of blood lipoperoxidation. The scheme of intensive care in conditions of decompensation of diabetes mellitus aimed at correction of pathobiochemical disturbances in patients with acute surgical endotoxicosis has been developed.


Assuntos
Abdome Agudo/cirurgia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Sepse/cirurgia , Abdome Agudo/sangue , Abdome Agudo/diagnóstico , Doença Crônica , Terapia Combinada , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Emergências , Feminino , Humanos , Peroxidação de Lipídeos , Masculino , Pessoa de Meia-Idade , Sepse/sangue , Sepse/diagnóstico , Procedimentos Cirúrgicos Operatórios
16.
Anesteziol Reanimatol ; (1): 13-8, 1996.
Artigo em Russo | MEDLINE | ID: mdl-8686933

RESUMO

Lipid peroxidation of cell membranes and liquid media of the organism were studied in 54 diabetics with the cholestatic syndrome, and fundamentals of antioxidant therapy of this cohort of patients discussed. The predominant efficacy of bio-oxidants has been revealed. The mechanism of their action is realized primarily at the stages of initiation and ramification of the chain of free radical oxidation. The authors searched for a sufficiently effective combination of antioxidants for the treatment of medium-severe and grave hepatodepression in patients with sub- and decompensated diabetes mellitus, as well as for the optimal method of antioxidant therapy.


Assuntos
Antioxidantes/uso terapêutico , Colestase/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Falência Hepática/tratamento farmacológico , Colestase/sangue , Colestase/etiologia , Colestase/cirurgia , Terapia Combinada , Complicações do Diabetes , Diabetes Mellitus/sangue , Quimioterapia Combinada , Humanos , Peroxidação de Lipídeos , Falência Hepática/sangue , Falência Hepática/etiologia , Falência Hepática/cirurgia , Período Pós-Operatório , Fatores de Tempo
17.
Khirurgiia (Mosk) ; (6): 19-21, 1990 Jun.
Artigo em Russo | MEDLINE | ID: mdl-2214568

RESUMO

Experiments were conducted to study the acid-base equilibrium of blood in pancreatitis and in combination with laser irradiation of venous blood by the intravascular method through a light guide. Irradiation of blood was attended by inhibition of metabolic acidosis development, which was evidently linked with improved blood oxygen transport function in response to exposure to the laser beam.


Assuntos
Equilíbrio Ácido-Base/efeitos da radiação , Acidose/radioterapia , Sangue/efeitos da radiação , Terapia a Laser , Pancreatite/radioterapia , Equilíbrio Ácido-Base/fisiologia , Acidose/sangue , Acidose/etiologia , Doença Aguda , Animais , Sangue/metabolismo , Cães , Feminino , Masculino , Pancreatite/sangue , Pancreatite/complicações
18.
Vestn Khir Im I I Grek ; 144(6): 106-10, 1990 Jun.
Artigo em Russo | MEDLINE | ID: mdl-2175472

RESUMO

Experimental investigations and experience with treatment of 74 patients with pancreonecrosis have shown the highest effectiveness of associated usage of hemosorption and external elimination of lymph from the thoracic duct. Associated detoxication for pancreonecrosis facilitates to rapidly decrease the level of the intoxication which is demonstrated by positive dynamics of biochemical and toxicological parameters of blood and lymph.


Assuntos
Drenagem/métodos , Hemoperfusão , Pâncreas/patologia , Pancreatite/terapia , Ducto Torácico/cirurgia , Toxemia/terapia , Doença Aguda , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Necrose , Pancreatite/complicações , Pancreatite/patologia , Toxemia/etiologia
19.
Vestn Khir Im I I Grek ; 140(2): 34-6, 1988 Feb.
Artigo em Russo | MEDLINE | ID: mdl-3388706

RESUMO

Experimental (118 experiments) and clinical (30 patients) investigations have shown a positive effect of endovascular irradiation of blood with the helium-neon and ultraviolet lasers on recovery of homeostasis in pancreatitis and peritonitis. The procedure stimulates the erythrocyte bioenergetics, reduces the degree of haemic hypoxia and increases nonspecific immunological reactivity.


Assuntos
Sangue/efeitos da radiação , Terapia a Laser , Pancreatite/radioterapia , Peritonite/radioterapia , Toxemia/radioterapia , Doença Aguda , Animais , Cães , Feminino , Humanos , Masculino , Pancreatite/sangue , Peritonite/sangue , Coelhos , Veia Subclávia
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