Assuntos
Neoplasias Abdominais/patologia , Neoplasias Abdominais/terapia , Neuroblastoma/patologia , Neuroblastoma/terapia , Neoplasias Abdominais/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Humanos , Lactente , Masculino , Neuroblastoma/tratamento farmacológico , Indução de RemissãoRESUMO
Twenty-five years experience of diagnosis and results of treatment of 143 childs aged from 10 days to 15 years with sizable mediastinal formations was summarized. Benign tumor was revealed in 50 (34.96%) childs, malignant one--in 93 (65.04%). Groups of most important symptoms were suggested: generally somatic, compressive, neurological. Principal method of diagnosis of mediastinal tumor in children--the survey roentgenography of thoracic organs in two projection. Immediate and late follow-up results of operative intervention were estimated, diagnostic mistakes were analyzed.
Assuntos
Neoplasias do Mediastino/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-IdadeRESUMO
Specific features and variability of microflora have been investigated in 75 patients with appendicular peritonitis. The patients' age was from 2 to 15. Forty-five (45) children had local peritonitis, 17, diffuse and 13 children had total peritonitis. Complications were found in 18 (49.5%) patients. Appendicular peritonitis in children was accompanied by the permanent competition and changes in microflora. Microbiological pattern depended on the process stage and varied during a rather short period. The abundance of microorganism species during local peritonitis was gradually replaced by the prevalence of Staphylococcus aureus and especially Escherichia coli under the spread inflammation. The change of microflora during post-operation period was observed in 21 patients (56.8%). In 9 patients the change was detected on the 15th--3rd day after the operation. Complications were observed in 85.7% of patients with changed microflora in the post-operation period. A conclusion was made that the prescription of the optimal antibacterial schemes of peritonitis treatment in children should be made with the account of change of bacterial agents during pathological process.
Assuntos
Abdome/microbiologia , Apendicite/microbiologia , Bactérias Aeróbias/isolamento & purificação , Peritonite/microbiologia , Doença Aguda , Adolescente , Apendicite/complicações , Líquido Ascítico/microbiologia , Bactérias Aeróbias/efeitos dos fármacos , Criança , Pré-Escolar , Humanos , Testes de Sensibilidade Microbiana/estatística & dados numéricos , Peritonite/etiologiaRESUMO
Bacterial contamination of the abdominal cavity was studied in 30 children aged from 2.5 to 14 years with acute abdominal conditions. Anaerobes were detected in 63.9% of the children. It was established that on the initial stages of development of acute diseases in the abdomen the antagonism between aerobes and anaerobes was not present. 3 days and later after surgery the antagonism between aerobes and anaerobes arises which results in potentiation of the inflammatory process by either aerobes (25% of cases) or anaerobes (75% of cases). The complicated course of postoperative period in patients with acute abdomen more than in 83% of cases is due to anaerobes and in 50%--to aerobes.
Assuntos
Abdome Agudo/microbiologia , Abdome/microbiologia , Bactérias Anaeróbias , Infecções Bacterianas/microbiologia , Abdome Agudo/cirurgia , Adolescente , Bactérias Anaeróbias/isolamento & purificação , Bactérias Anaeróbias/patogenicidade , Criança , Pré-Escolar , HumanosRESUMO
The peculiarities of pre-, intra- and early postoperative period course in 108 children, operated on for diffuse and general peritonitis of appendicitis origin, are studied. Most significant 34 prognostic factors for the disease outcome are choosed. The leading factors are the disease course duration, general condition of the patient while hospitalization, the vegetative disorders presence, the intestinal paresis degree, the biochemical inductors of stress contents, the peritoneal exudate character, the kind and composition of microorganisms in it, the character of an early postoperative period course.
Assuntos
Apendicite/complicações , Peritonite/etiologia , Peritonite/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Peritonite/diagnóstico , Período Pós-Operatório , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
The system of objective estimation of children severity state before and after an urgent operations conduction for the acute disease of abdominal cavity and retroperitoneal space. Three types of the disease course were delineated on the basis of 200 patients, ageing from 3 months to 15 years, examination. While stable course the conservative therapy conduction is indicated, while instable--the intensive therapy, incorporating the extrarenal depuration methods, and the operations when indicated; while the progressing, testifying the incomplete sanation of abdominal cavity--the relaparotomy and intensive therapy.
Assuntos
Gastroenteropatias/complicações , Gastroenteropatias/diagnóstico , Doença Aguda , Adolescente , Criança , Pré-Escolar , Progressão da Doença , Humanos , Lactente , Prognóstico , Índice de Gravidade de DoençaRESUMO
The results of treatment of 60 children with complete adhesive ileus (CAI), occurring from 6 mo till 10 yrs after appendectomy conduction, were analyzed. Complex biochemical and immunological examination was conducted in 30 patients. There were 10 biopsies of parietal peritoneum examined. The obtained clinical, biochemical, immunological and morphological features may be applied for reliable prognostication of the CAI occurrence, complications course and outcome. Long observation and rehabilitational measures conduction is indicated in the patients with high risk of the peritoneal adhesive disease occurrence.
Assuntos
Doenças do Íleo/cirurgia , Obstrução Intestinal/cirurgia , Linfócitos B/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/imunologia , Imunoglobulina A/imunologia , Lactente , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/imunologia , Masculino , Linfócitos T Auxiliares-Indutores/imunologiaAssuntos
Abdome Agudo/diagnóstico , Antioxidantes , Peroxidação de Lipídeos , Estresse Fisiológico/diagnóstico , Abdome Agudo/sangue , Abdome Agudo/complicações , Abdome Agudo/cirurgia , Adolescente , Biomarcadores/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Período Pós-Operatório , Estresse Fisiológico/sangue , Estresse Fisiológico/etiologia , Estresse Fisiológico/cirurgiaAssuntos
Abdome Agudo/cirurgia , Enteropatias/cirurgia , Estresse Fisiológico/prevenção & controle , Abdome Agudo/sangue , Fatores Etários , Analgésicos Opioides/administração & dosagem , Sangue/efeitos da radiação , Criança , Hemoperfusão , Humanos , Oxigenoterapia Hiperbárica , Enteropatias/sangue , Plasmaferese , Complicações Pós-Operatórias , Promedol/administração & dosagem , Estresse Fisiológico/etiologia , Fatores de Tempo , Raios UltravioletaRESUMO
The results of operative treatment of 51 patients with primary vesico-ureteric reflux followed from 6 mos to 11 yrs were analyzed. Glenn-Andersen method modification of clinic was used. Conclusion was made about the advantages of one-moment bilateral ureters transplantation over the staged treatment in children with bilateral vesico-ureteric reflux. Good result was noted in 57 (77%) observations after 74 plastic operations.
Assuntos
Refluxo Vesicoureteral/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Métodos , Fatores de Tempo , Ureter/cirurgia , Bexiga Urinária/cirurgiaRESUMO
The results of treatment of 139 patients with congenital pyelo-ureteric segment (PUS) narrowing were analyzed. Plastic operation was conducted in 117 of them, PUS plasty with the flap application--in 22. The prognostic significance of sign's norm deviations of the PUS diameter and length ratio as a risk factor was studied to substantiate the numerical criterion--of operation method choice. In accordance with this prognostic significance the value of Student's criterion was calculated. When the value of ratio is no more than 0.3--the narrowed part resection with subsequent ureteropelviostomy is indicated, and when this value is 0.31 or more--the PUS plasty with the flap application.
Assuntos
Hidronefrose/cirurgia , Rim/anormalidades , Ureter/anormalidades , Criança , Constrição Patológica/congênito , Constrição Patológica/diagnóstico , Seguimentos , Humanos , Hidronefrose/etiologia , Métodos , Modelos Teóricos , Fatores de Risco , Fatores de TempoAssuntos
Hidronefrose/cirurgia , Pelve Renal/cirurgia , Nefrostomia Percutânea/métodos , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Adolescente , Anastomose Cirúrgica/métodos , Criança , Pré-Escolar , Feminino , Humanos , Hidronefrose/congênito , Hidronefrose/etiologia , Masculino , Fatores de Tempo , Obstrução Ureteral/complicações , Obstrução Ureteral/congênitoAssuntos
Hidronefrose/cirurgia , Pelve Renal/cirurgia , Pielonefrite/complicações , Ureter/fisiopatologia , Obstrução Ureteral/complicações , Derivação Urinária/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Hidronefrose/etiologia , Lactente , Pelve Renal/fisiopatologia , Masculino , Período Pós-Operatório , Pielonefrite/cirurgia , Obstrução Ureteral/congênito , Obstrução Ureteral/cirurgiaRESUMO
On the basis of mathematical analysis of the long-term results of operative treatment of 119 children with unilateral hydronephrosis caused by congenital obstruction of the pyelo-ureteral segment, the prognostically significant signs (risk factors) having unfavourable effect on the outcome of an operation were revealed. In retrospective analysis, the main types of the course of unilateral hydronephrosis in children were distinguished. In stable course, the conservative therapy is indicated, in non-stable--the intensive medicamentous therapy, or repeated corrective operation, in progressive--nephroureterectomy .