[Treating bronchoscopy at ventilator-associated pneumonia in critically ill patients].

On the material, based on the experimental treatment of broncho-pulmonary derangements, including ventilator-associated pneumonias, at 105 critically ill patients, the authors recommend methods of prophylaxis and treatment of these types of pathologies, which are based on the suction fibrobronchoscopy with the use of different suction mixtures. The more satisfying evolvement of pathological processes, decrease of the expressing of the degree of clinical appearance and intoxication, the indisputable improvement of dynamics of the condition of the patient and subsidence of the average continuation of treatment prove the advantage of this method. The important economical effect is also achieved with the subsidence of the price of daybeds, decrease of the expenses of the diagnostics and cures. The achieved results give us the permission to recommend the widespread use of the treating suction fibrobronchoscopy when treating patients with acute diseases of lungs, advantages at VAP. The expressed efficiency, reliability and the important economical effect are the base priorities of this method.

[Endoscopic treatment in critically ill patients with upper gastrointestinal bleeding].

The goal of the current research was to ascertain the optimal methods of an endoscopic haemostasis in critical care patients with GDB. The research was conducted on critically ill patients. The different endoscopic methods of treatment: injectional hemostasis, irrigation with local hemostatics, thermo coagulation, and combined method were used. Treatment with injectional hemostasis resulted in hemostasis in 75% of patients. Irrigation with local hemostatics was conducted using the local hemostatic agent caprofer and (or) 10% solution of epsylonaminocapronal acid. The final hemostasis was achieved in the 90% of the cases; bleeding was stopped in 85% of the cases when the hemorrhages occurred from chronic ulcers. The effect of thermo coagulation method was 80-85%. Combined method of treatment (combination of the irrigation with caprofer and thermo coagulation) helped to achieve 95% of the final hemostasis in critically ill patients. The achieved results certify that the combined use of caprofer and method of electro coagulation in critical care patients with GDB is very perspective. Simultaneously with this, it is also recommended to use anti-segregation therapy with blockers of proton pomp and boosting the defense of the mucous tissue with high doses of mucogen.

[Sudden death after an operation for gall stones]. / Neozhidannaia smert' posle operatsii po povodu zhelchnokamennoi bolezni.

During 10 years 3000 patients were operated upon for chronic calculous cholecystitis. Twenty of these patients died during 30 days after operation, in 16 of them death resulted from incompetence of the vital organs. Endotoxicosis and polyorganic insufficiency after technically correct operations for chronic calculous cholecystitis are thought by the authors to be a variant of anaerobic infection with possible development of sepsis.

[Use of a plasmatic surgical device for hemostasis in injuries of parenchymal organs]. / Primenenie plazmennoi khirurgicheskoi ustanovki dlia gemostaza pri povrezhdeniiakh parenkhimatoznykh organov.

The article presents experimental grounds and clinical experiences for using a plasma device in 58 patients. Sufficiently high efficiency and safety of the method used during surgical procedures for arrest of bleedings from parenchymatous organs is proved.

[Characteristics of the healing of wounds of the stomach, intestines and liver after exposure to the plasma scalpel]. / Osobennosti zazhivleniia ran zheludka, kishki i pecheni pri vozdeistvii plazmennogo skal'pelia.

Results of experimental application of plasma surgical device UMPR-20 in operations on the stomach, intestine and liver in acute and chronic experiments are described. Coagulating properties of the plasma jet were detected responsible for reliable hemostasis in dissection of the parenchymatous organs. As compared with other surgical devices (electroknife, ultrasonic scalpel, laser "Scalpel-1" device) the zone of injury of the underlying tissues is much less and makes up 0.2-0.3 mm. The plasma surgical device UMPR-20 has good prospects in using during operations on parenchymatous organs and for treatment of their injuries.

[Characteristics of morphologic diagnosis of malignant transformation of chronic duodenal ulcer during its surgical treatment]. / Osobennosti morfologicheskoi diagnostiki ozlokachestvleniia khronicheskoi iazvy zheludka pri ee operativnom lechenii.

Under investigation were results of gastric biopsies, tissues of ulcers dissected during operation and findings of an analysis of preparations in paraffin sections. Findings of all the three diagnostic methods were shown to be completely identical in 63 patients (chronic ulcer in 54 of them, malignant ulcer--in 9). Errors took place in 17 patients. Causes of the errors are discussed. Practical recommendations are given.

[Malignant stomach ulcer]. / Malignizirovannaia iazva zheludka.

The authors present data of the clinical X-ray and morphological diagnostics of malignant gastric ulcers revealed in 96 patients. The total number of patients with gastric ulcer operated upon was 642. The morphological findings may serve the only reliable criterium of malignancy. Results of the operative treatment of such a malignant ulcer of the stomach are dependent on the spread of malignant invasion in the gastric wall. Treatment of patients with the involved mucosa only gave 5-year survival in 89.5%. Spread of the malignant invasion throughout the whole thickness of the gastric wall--50.0%. In patients with metastases into lymph nodes (independent of the invasion into the gastric wall) 5-year survival made up 29.4%.