ABSTRACT
Experience of treatment of chronic wounds in 11 patients in 2014 2016 yrs was analyzed. The impact of negative pressure, using domestically manufactured apparatus «ÐGÐТ- 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. Ðfficacy 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.
Subject(s)
Hyaluronic Acid/therapeutic use , Leg Injuries/therapy , Negative-Pressure Wound Therapy/methods , Skin Transplantation/methods , Suppuration/therapy , Wounds, Penetrating/therapy , Adult , Aged , Aged, 80 and over , Bandages , Chronic Disease , Combined Modality Therapy , Female , Humans , Leg Injuries/pathology , Leg Injuries/surgery , Lower Extremity/pathology , Lower Extremity/surgery , Middle Aged , Ointments , Retrospective Studies , Suppuration/pathology , Suppuration/surgery , Transplantation, Autologous , Treatment Outcome , Wounds, Penetrating/pathology , Wounds, Penetrating/surgeryABSTRACT
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.
Subject(s)
Duodenal Ulcer/surgery , Gastrointestinal Hemorrhage/surgery , Hemostasis, Endoscopic/methods , Stomach Ulcer/surgery , Adult , Duodenal Ulcer/diagnostic imaging , Duodenal Ulcer/pathology , Duodenoscopy , Esophagoscopy , Female , Gastrointestinal Hemorrhage/diagnostic imaging , Gastrointestinal Hemorrhage/physiopathology , Gastroscopy , Humans , Male , Middle Aged , Recurrence , Stomach Ulcer/diagnostic imaging , Stomach Ulcer/pathologyABSTRACT
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.
Subject(s)
Endocrine System/physiopathology , Gastric Mucosa/pathology , Intestinal Mucosa/pathology , Peptic Ulcer Hemorrhage/surgery , Peptic Ulcer/surgery , Catecholamines/blood , Endoscopy, Digestive System , Gastric Mucosa/metabolism , Gastric Mucosa/microbiology , Humans , Intestinal Mucosa/metabolism , Intestinal Mucosa/microbiology , Klebsiella pneumoniae/isolation & purification , Nitric Oxide Synthase Type II/metabolism , Peptic Ulcer/blood , Peptic Ulcer/pathology , Peptic Ulcer/physiopathology , Peptic Ulcer Hemorrhage/blood , Peptic Ulcer Hemorrhage/pathology , Peptic Ulcer Hemorrhage/physiopathology , Serotonin/blood , Severity of Illness Index , Streptococcus/isolation & purificationABSTRACT
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.
Subject(s)
Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/therapy , Hemostasis, Endoscopic/methods , Pregnancy Complications/epidemiology , Pregnancy Complications/prevention & control , Dexamethasone/administration & dosage , Dexamethasone/adverse effects , Dexamethasone/therapeutic use , Endoscopy, Digestive System , Epinephrine/administration & dosage , Epinephrine/adverse effects , Epinephrine/therapeutic use , Female , Fetal Death/chemically induced , Fetal Death/epidemiology , Fetal Death/prevention & control , Gastrointestinal Hemorrhage/surgery , Hexoprenaline/administration & dosage , Hexoprenaline/adverse effects , Hexoprenaline/therapeutic use , Humans , Incidence , Isotonic Solutions , Pre-Eclampsia/chemically induced , Pre-Eclampsia/epidemiology , Pre-Eclampsia/prevention & control , Pregnancy , Pregnancy Complications/surgery , Pregnancy Trimester, Third , Recurrence , Retrospective Studies , Sodium Chloride/administration & dosage , Sodium Chloride/adverse effects , Sodium Chloride/therapeutic use , Vasoconstrictor Agents/administration & dosage , Vasoconstrictor Agents/adverse effects , Vasoconstrictor Agents/therapeutic useABSTRACT
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.
Subject(s)
Peptic Ulcer Hemorrhage/diagnosis , Serotonin/blood , Severity of Illness Index , Stomach Ulcer/diagnosis , Adult , Aged , Case-Control Studies , Endoscopy, Digestive System , Female , Gastric Mucosa/enzymology , Gastric Mucosa/pathology , Humans , Male , Middle Aged , Nitric Oxide Synthase Type II/metabolism , Peptic Ulcer Hemorrhage/blood , Peptic Ulcer Hemorrhage/etiology , Peptic Ulcer Hemorrhage/pathology , Predictive Value of Tests , Prognosis , Recurrence , Stomach Ulcer/blood , Stomach Ulcer/complications , Stomach Ulcer/pathologyABSTRACT
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.
Subject(s)
Epinephrine/blood , Gastrointestinal Hemorrhage/therapy , Hemostasis, Endoscopic , Norepinephrine/blood , Peptic Ulcer Hemorrhage/therapy , Peptic Ulcer/therapy , Stomach Ulcer/therapy , Duodenum/metabolism , Duodenum/pathology , Gastric Mucosa/metabolism , Gastrointestinal Hemorrhage/blood , Gastrointestinal Hemorrhage/complications , Gastrointestinal Hemorrhage/diagnosis , Humans , Intestinal Mucosa/metabolism , Intestinal Mucosa/pathology , Nitric Oxide Synthase Type II/blood , Peptic Ulcer/blood , Peptic Ulcer/complications , Peptic Ulcer/diagnosis , Peptic Ulcer Hemorrhage/blood , Peptic Ulcer Hemorrhage/complications , Peptic Ulcer Hemorrhage/diagnosis , Prognosis , Stomach/pathology , Stomach Ulcer/blood , Stomach Ulcer/complications , Stomach Ulcer/diagnosis , Time FactorsABSTRACT
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.
Subject(s)
Endoscopy, Digestive System/methods , Hemostasis, Endoscopic/methods , Hemostasis, Surgical/methods , Peptic Ulcer Hemorrhage/surgery , Data Interpretation, Statistical , Humans , Peptic Ulcer Hemorrhage/diagnosis , Secondary Prevention , Treatment OutcomeABSTRACT
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.
