Sklifosovsky Journal "Emergency Medical Care" / Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь»
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АЛГОРИТМ ДИАГНОСТИКИ И ЛЕЧЕНИЯ ПОСТРАДАВШИХ С ТРАВМОЙ ТАЗА, ОСЛОЖНЕННОЙ ЗАБРЮШИННЫМ КРОВОИЗЛИЯНИЕМ
Get PDFIntroduction. Despite great diagnostic and therapeutic advances, the amount of complications and mortality rate in patients with retroperitoneal hemorrhage associated with pelvic trauma remains high. The primary aim of treatment in such patients is early recognition and arrest of bleeding source and intensive therapy. Thus, the development of diagnostic and treatment algorithm is important for improvement the results of treatment of patients with pelvic trauma complicated by retroperitoneal hemorrhage.The aim of the study is to evaluate the effectiveness of the developed algorithm for diagnosis and treatment of patients with pelvic trauma complicated with retroperitoneal hemorrhage.Material and Methods. Retrospective comparative analysis was performed in 374 patients with pelvic fractures complicated with retroperitoneal hemorrhage who were admitted to our hospital from 2007 to 2015. The study group consisted of 164 patients who were treated according to the new algorithm for diagnosis and treatment. The control group consisted of 210 patients who were not treated with the developed algorithm.Results. Clinical use of the developed algorithm led to reduction in mortality from 12.2 to 9.7%. The number of common complications decreased from 41.3 to 25.0%, and local complications decreased from 28.6 to 18.9%. The time of patients’ activation after the definitive fixation of pelvis reduced from 17.5 to 7.6 days. The average hospital stay decreased from 46.1 to 35.2 days.Conclusion. The developed diagnostic and treatment algorithm helped reduce mortality rate, the number of general and local complications in patients with pelvic trauma complicated by retroperitoneal hemorrhage as well as the duration of bed rest and hospital stay
АПОПТОЗ КЛЕТОК КРОВИ У ГЕРОНТОЛОГИЧЕСКИХ БОЛЬНЫХ С ОСТРЫМИ ОТРАВЛЕНИЯМИ ПСИХОФАРМАКОЛОГИЧЕСКИМИ ПРЕПАРАТАМИ
Get PDFWe studied apoptosis of peripheral blood cells in 47 patients older than 60 years with varying course and outcome of acute poisoning with psychopharmacological drugs. It is shown that a control group of volunteers of the same age should be formed for an objective assessment of these disturbances. We revealed deviation of apoptotic parameters from the control group values. However, we failed to specify its information value for the prognosis and disease outcomeУ 47 больных старше 60 лет с различным течением и исходом острых отравлений психофарма- кологическими препаратами изучен апоптоз клеток периферической крови. Показано, что для объективной оценки нарушений следует формировать контрольную группу из добровольцев та- кого же возраста. Выявлены отклонения показателей апоптоза от значений контрольной группы. Однако не удалось установить их информативность для прогноза течения и исхода заболевания
К 75-ЛЕТИЮ ВИКТОРА АЛЕКСАНДРОВИЧА ТУТЕЛЬЯНА
Get PDF.8 февраля 2017 г. свой 75-летний юбилей встречает крупный ученый в области биохимии, гигиены и токсикологии питания и талантливый организатор медицинской науки академик РАН Виктор Александрович Тутельян
БЕЗОПАСНОСТЬ СМЕШАННОГО ИСКУССТВЕННОГО ПИТАНИЯ У ПОСТРАДАВШИХ С ТЯЖЕЛОЙ СОЧЕТАННОЙ ЧЕРЕПНО- МОЗГОВОЙ ТРАВМОЙ
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АЛГОРИТМ ДИАГНОСТИКИ И ЛЕЧЕНИЯ БОЛЬНЫХ ПОЖИЛОГО И СТАРЧЕСКОГО ВОЗРАСТА С ОСТРЫМ ХОЛЕЦИСТИТОМ, ХОЛЕДОХОЛИТИАЗОМ И МЕХАНИЧЕСКОЙ ЖЕЛТУХОЙ
Get PDFWe performed a retrospective analysis of treatment in 4,197 patients with acute cholecystitis. Destructive complicated cholecystitis was diagnosed in 658 (25.3%) patients . There were 431 (65.5%) patients of elderly and senile age. All patients had comorbidities. Cardiovascular insufficiency — 73.9%, respiratory diseases — 29.2%, diabetes — 26%. For urgent indications, 12 (2.8%) patients were operated, 2 (16.6%) of them died. In 419 (97.2%) patients, mini-invasive treatment was performed. Endoscopically, jaundice wasn’t managed in 86 (20.5%) cases. In 62 (14.8%) cases, percutaneous transhepatic microcholangiography was performed under ultrasound guidance. Laparoscopic cholecystectomy was performed in 183 (43.6 %) cases, traditional cholecystectomy was performed in 149 (35.6%) cases, and in 38 of them (23.9%) it was combined with Kerr’s drainage of choledoch. Mini-invasive cholecystectomy was performed in 87 (20.7%) cases. Postoperative complications were revealed in 21 (5.0%) patients, in 7 (2.9%) of elderly age and 14 (7.9%) of senile age. Postoperative mortality rate was 2.0%. The use of minimally invasive interventions in the complex treatment of this group of patients was the main goal and it was reasoned by the severity of the initial condition of elderly and senile patients