scholarly journals The Effectiveness Of The Use Of Transtrachial Sanitation In The Treatment Of Patients With Lung Abscess Complicated By Bronchial Fistula

Author(s):  
Safoev B.B. ◽  
◽  
Khasanov A.K. ◽  
Rakhimov A.Ya. ◽  
Mirsoliev Sh.G. ◽  
...  

The results of the research of 44 patients with lung abscesses complicated by bronchial fistula of various etiology, who were treated in the purulent surgical department in the clinical base of the Bukhara State Institute in 2010-2019, were analyzed. All patients, depending on the method of treatment, were divided into 2 groups: I - comparison group and II - main. The controlled group I consisted of 31 (70.4%) patients who received traditional (conservative) methods of treatment. The II - main group included 13 (29.5%) patients who, in addition to conservative treatment, underwent transtrachial drainage of a purulent focus with sanitation with antibacterial and diluting drugs (trypsin, chymotrypsin). The analysis of the obtained results revealed that although transtrachial drainage of a purulent focus of the lung is a more effective method than conservative treatment, it also has its drawbacks in the form of complications such as: tracheobronchitis 23.1%, suppuration of soft tissues in the area of microtrachestomy 15.4%, bronchospasm 7.6%, self-extradition of the catheter 23.1%, from the purulent cavity and loss of microdrainage 7.6%.

2021 ◽  
Vol 74 (10) ◽  
pp. 2566-2568
Author(s):  
Tunzala V. Ibadova ◽  
Vitalii V. Maliar ◽  
Volodymyr V. Maliar ◽  
Vasyl V. Maliar

The aim: To evaluate the peculiarity of clinical manifestations of neonatal respiratory distress syndrome (NRDS) in deeply premature infants from mothers with phenotypic markers of undifferentiated connective tissue dysplasia (UCTD). Materials and methods: The study represent the results of a retrospective clinical and statistical analysis of 268 premature birth report card and newborn report sheet. .The main (1 group) included 50 pregnants with obvious phenotypic markers of UCTD, the comparison group (group 2) consisted of 50 pregnant women without phenotypic markers of UDCTD. Results: According to the study, in 12 (24%) pregnant women of the main group at the time of admission to the clinic had contractions,which required specific therapy. Cervical cerclage was performed in 38 (76%) patients of the main group due to the presence of cervical insufficiency (CI). In these cases, the severity of the CI on the Steinber scale was 7.2 ± 0.4 points in the main group against 4.4 ± 0.2 points in the comparison group (p <0.05). Group I patients were more likely to have complications of labor such as:premature rupture of membranes, uterine contraction abnormalities and fetal distress, which required in most cases cesarean delivery (7% and 2%), respectively (p <0.05). The incidence of neonatal complications requiring respiratory support was 67% in group I and 48% in group II. According to our observations, the clinical manifestations of bronchopulmonary dysplasia were twice as high in infants of the main group (66%) against (44%) of the comparison group (p <0.05). Conclusions:1.Neonatal respiratory distress syndrome in premature infants is more often associated from mothers with UDCTD. 2. The high importance of steroid prophylaxis of NRDS and antioxidant therapy in reducing the frequency of mechanical ventilation and the development of bronchopulmonary pathology, especially in infants from mothers with UDCTD syndrome, has been proven. 3. The possibility of diagnosing disorders of functional maturation of the lungs in the fetal period using a non-invasive method of ultrasonography has been confirmed.


2021 ◽  
pp. 43-47
Author(s):  
V. Kupriyanchuk ◽  
Y. Bunin ◽  
R. Mikhailusov ◽  
V. Negoduyko ◽  
E. Khoroshun ◽  
...  

Summary. The purpose of the study is to establish the indications and contraindications for the removal of foreign bodies of lungs of gunshot origin. Materials and methods. In the surgical department of the surgical clinic of the Military Medical Clinical Center of the Northern Region, 207 wounded who received gunshot wounds penetrating the chest were examined. The wounded were divided into 2 groups depending on the operational tactics used. The main group of 97 wounded who were treated using modern video endoscopic technology and magnetic surgical instruments. The comparison group consisted of 110 wounded who received traditional treatment. Results and their discussion. Using video endoscopic technologies and magnetic surgical instruments during surgery, 42 (54.5%) in the main group were removed, in the comparison group — 23 (27.4%) foreign bodies. The amount of surgery should not exceed the amount of damage that minimizes surgical trauma. The article presents indications and contraindications to the removal of foreign bodies of pulmonary origin. The differential approach allows to determine the surgical tactics depending on the location of the foreign body, its size and the fit of foreign bodies to the vessels, bronchi, mediastinum. Adherence to the rules of removal of foreign bodies of the lung, depending on the location of its location and size leads to a decrease in inappropriate surgical interventions and postoperative complications. Conclusions. 1. The distribution of foreign bodies by location and size allows you to clearly determine the tactics of treatment and avoid postoperative complications. 2. Surgical interventions to remove foreign bodies should be performed in the first days after stabilization of the patient’s condition using minimally invasive technologies.


Author(s):  
E.B. Tatarnikova ◽  
◽  
O.I. Krivosheina ◽  

Aim. To study the clinical and functional effectiveness of a complex method of treatment of dry eye syndrome against the background of chronic peripheral uveitis, including local tear-replacement and anti-inflammatory therapy in combination with laser retinal coagulation on the extreme periphery of the fundus. Materials and methods. The study was performed among 98 patients who made up 2 follow-up groups: the main group (78 people) and the comparison group (20 people). All patients underwent OSDI questionnaires, visometry, pneumotonometry, biomicroscopy of the anterior segment of both eyes, binocular ophthalmoscopy with sclerocompression, and the Schirmer I test. In the main group, along with conservative treatment, laser coagulation of the extreme periphery of the retina was performed, in the comparison group - conservative treatment. The follow-up period was 3 months. Results and discussion. The use of a complex method of treatment of «dry eye» syndrome against the background of chronic peripheral uveitis significantly reduces the number of complaints according to the OSDI questionnaire, improves the condition of the eye surface (reducing the overhang of the conjunctival fold, the severity of «sluggish» hyperemia of the conjunctiva of the eyelids and transitional folds, reducing the amount of conjunctival discharge). The indicator of total tear production in the main group after 3 months. it increases by 1,5 times in comparison with the initial data, and in 100% of cases, stable relief of inflammation of the chorioretinal structures on the extreme periphery of the fundus is provided. Conclusion. A new effective method for the treatment of dry eye syndrome against the background of chronic peripheral uveitis, including local tear-replacement and anti-inflammatory therapy in combination with laser retinal coagulation on the extreme periphery of the fundus, has been developed and introduced into clinical practice. The use of this method provides stable clinical and functional results in the long-term period and can be recommended for the treatment of «dry eye» syndrome of mild to moderate severity against the background of chronic peripheral uveitis. Key words: dry eye syndrome, chronic peripheral uveitis, laser coagulation of the extreme periphery of the retina.


2020 ◽  
Vol 13 (2) ◽  
pp. 109-115
Author(s):  
Nadezhda Anatol'evna Zubareva ◽  
Dmitriy Yur'evich Sosnin ◽  
Andrey Viktorovich Renzhin

Introduction. Currently there are no relevant findings from a comparative study of the chemical composition of the abscess fluid and blood serum.The aim of the research was to study the composition of procalcitonin (PCT) contained in the blood serum and abscess fluids of the soft tissues and the abdominal cavity in local inflammation and sepsis.Materials and methods. The PCT concentration was determined in blood serum and the content of abscesses of the soft tissues and abdominal cavity in 45 patients of the surgical department. The experimental group included 31 patients with inflammatory processes that did not result in the organ failure. The comparison group included 14 patients with abscesses which manifested clinical and laboratory signs of the systemic inflammation and organ failure. The control group included 25 healthy individuals. The PCT level was determined by ELISA using the Procalcitonin - ELISA - BEST test system (Vector - Best, Russia).Results. Differences in the PCT content in the serum between groups were characterized by a high degree of statistical significance (H = 58.79206, p = 0.0000). The highest PCT level in the serum was observed in patients of the comparison group, where the average values ​​were 11.94 4.98 ng / ml, the lowest PCT level in the serum was observed in patients of the control group. The PCT concentration in the content of abscesses was lower compared to blood serum and was characterized by statistically significant differences in patients of both - experimental group and comparison groups (p = 0.00001)Conclusion. Abscesses of the soft tissues and the abdominal cavity without signs of generalized infection are not accompanied by an increase in the PCT concentration in the blood serum for more than 2 ng/ml. The PCT concentration in the content of abscesses was lower than its content in the blood serum in both - the local inflammatory process and in the development of sepsis.


2019 ◽  
Vol 86 (7) ◽  
pp. 36-41
Author(s):  
V. I. Liakhovskyi ◽  
O. M. Bezkorovaynyy ◽  
A. V. Sydorenko

Objective. To study the impact of sulodexide on the healing process of trophic ulcers of the mixed genesis in the lower extremities. Materials and methods. Analysis of the medical cards data was done for 105 patients, who in 2015 - 2019 yrs have had treated the trophic ulcers of the mixed genesis of the ankles in Department of Vascular Surgery of the Poltava Regional Clinical Hospital. The causes of development of trophic ulcers were confirmed by data of ultrasonographic color angioscanning of the lower extremities and pelvis with measurement of the ankle-brachial pressure index and arteriography. All the patients did not accepted the proposal for performing of correcting and restoration surgical treatment on the lower extremities vessels. Depending on the treatment prescribed the patients were divided into two groups. Into the Group I (comparative) 53 (50.5%) patients were included, who obtained a casual conservative treatment, directed to improvement of the lower extremities blood supply, as well as the blood rheological properties, which included venotonic, analgesic, antibacterial preparations and local treatment, depending on the wound process stage. Into the Group II (the main) 52 (49.5%) patients were included, who on the background of typical treatment have obtained sulodexide in a dose 600 LU (lipoproteidlipase units) on 200 ml of physiological solution of sodium chloride up to 15 days long with subsequent therapy in the dose of 1 capsule twice a day (500 LU) during up to 60 days. In the Group I there were 32 (60.4%) men and 21 (39.6%) women, and in the Group II – 30 (57.7%) men and 22 (42.3%) women. Average age of patients in the Group I have constituted (65.8 ± 4.38), and in the Group II – (66.2 ± 5.04) yrs old. The pain intensity in accordance to the ten-point numerical rating scale was checked before the treatment beginning, in 7 and 14 - 15 days, the trophic ulcers square was measured, local temperature of the patient’s body, pН-metry and cytological investigations of the wounds exudate were done in all the patients before the treatment. Besides this, 38 (71.7%) patients of the comparison group and 40 (76.9%) patients of the main group were followed during 90 - 120 days after leaving a stationary. Results. In the patients, who have obtained sulodexide additionally, reparative processes in the trophic ulcers regions of the lower extremities have become accelerated, the pain syndrome have been lowered rapidly, the water index normalized, the blood supply improved, the ankle-brachial index enhanced, a local temperature raised, cytological picture of the wound exudate improved, what promoted more rapid healing of ulcers and reduction of the stationary stay duration. During the planned visits of the patients in 90 - 120 days a complete healing of trophic ulcers of the lower extremities in 31 (77.5%) patients of the main group and in 24 (63.2%) patients of the comparison group was proved. Conclusion. Application of sulodexide in the treatment dosage is expedient to include into complex of treatment for trophic ulcers of the mixed origin in the lower extremities.


Morphologia ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 7-15
Author(s):  
O. O. Bilyayeva ◽  
O. O. Dyadyk ◽  
V. I. Zaritsʹka ◽  
Ye. Ye. Kryzhevskyi

Objective. To prove experimentally the effectiveness of a new generation of application sorbent by studying the morphological changes during the wound process. Methods. Depending on the drug used to treat purulent wounds, we divided the animals into three groups. In the main group (group I) the study was performed on 20 rats, they used an application sorbent, which includes aerosil with immobilization on its matrix ornidazole (Patent of Ukraine for utility model № 115228). The comparison group (group II) consisted of 10 rats, which used the known sorbent "Gentaxan", which includes: gentamicin sulfate, L-tryptophan and zinc sulfate. The comparison group (group III) was 10 rats. In this group for the treatment of purulent wounds used 10% sodium chloride solution, followed by a transition to ointment "Levomekol", which includes chloramphenicol and methyluracil. Results. The results of the study show that in the main group already on the seventh day in comparison with the comparison groups was found granulation tissue with a large number of newly formed vessels of the microcirculatory tract and pronounced proliferation of fibroblasts, indicating acceleration of wound healing. In the comparison groups, the regeneration process was slower. Conclusion. Pathomorphological examination revealed that drugs with sorption properties contribute to a faster reduction of edema and inflammation, and treatment with application sorbent used in the main group, significantly accelerates the processes of connective tissue repair and wound epithelization, ie accelerates wound healing processes with comparison groups.


Author(s):  
Alina Alexandrovna Serekova ◽  
Madina Georgievna Dzgoeva ◽  
Zalina Georgievna Dzgoeva ◽  
Azamat Borisovich Kokoev ◽  
Larisa Stanisla vovna Kanukova ◽  
...  

The program of standard therapeutic measures in 45 patients with Generalized Chronic Periodontitis (GCP) and background hypertension, group I(a), included hirudotherapy, for comparison, the effectiveness of traditional treatment was evaluated in 40 patients, group I(b), who refused to use medical leeches. In the second comparison group (35 patients), patients with GCP, but normal blood pressure, also received only a set of traditional methods of treatment. The inclusion of hirudotherapy in the program of therapeutic measures in patients with GCP and hypertension makes it possible to optimize the onset of a persistent therapeutic effect, lengthen the period of remission of the pathological process in periodontal disease and significantly improves the quality of life of patients.


Introduction. An important component of the treatment of gunshot wounds is antibiotic therapy. Unfortunately, due to the antibiotic resistance of many strains of microorganisms, there remains a risk of purulent- infectious complications even with prolonged antibiotic therapy. In recent years, methods of physical action, in particular, photodynamic therapy (PDT), have been used to accelerate bacterial decontamination of wounds. Gunshot wounds have their own characteristics that create certain difficulties for the application of the method of photodynamic therapy. Purpose. Аnalyzes the results of the application of the developed PDT method in the complex treatment of gunshot wounds of soft tissues. Materials and methods. A comparison was made of the main indicators of the wound healing process between the wounded of the main group who used PDT (n = 52) and the comparison group (n = 32) who used treatment with complex water-soluble ointments. To increase the effectiveness of the method, the «Photolon» photosensitizer was administered in two ways: by injection infiltration of tissues around the wound and by application directly to the wound surface. The wavelength of laser radiation is 660 nm. The dose of laser energy was 20 J/cm2. Results. The results of the study showed an improvement in the course of the wound process in all respects when using PDT: the period of regression of local edema in the main group on (3.7 ± 0.4) days in the comparison group (6.2 ± 0.5), the period of wound cleansing (4.7 ± 0.6) days (7.3 ± 0.8) days, respectively; the timing of the start of granulation (4.6 ± 0.5) days and (7.8 ± 0.6). At the beginning of treatment, 45 pathogenic strains were isolated in 38 (73.1 %) wounded main groups and 26 strains in 22 (68.7 %) wounded comparison groups. A day after the use of PDT, pathogenic wound microflora was isolated in 5 (9.6 %) wounded main groups — 5 strains and 23 strains in 19 (59.4 %) wounded comparison groups. Conclusions. The effects of PDT were observed: rapid inactivation of pathogenic wound microflora, reduction of edema, pain syndrome and stimulation of granulation growth, which contributes to early closure of wounds.


2019 ◽  
Vol 36 (4) ◽  
pp. 27-32
Author(s):  
R. B. Safarova

Aim. To study the hormonal status in pregnant women of older reproductive age and estimate the influence of administration of medical ozone on the course of pregnancy. Materials and methods. Ninety pregnant women aged 3544 years were examined over the period from 2013 to 2015. They were randomized by their age, social factors, associated gynecological and extragenital diseases. The main group (group I) joined 30 patients, the group of comparison (group II) 30 patients and the control (group III) 30 patients. All the patients underwent clinical and laboratory investigations according to the existing standards of obstetric examination. In the main group, complex treatment included therapy with medical ozone. In the comparison group, a standard medico-preventive therapy by the protocol №05 (20.02.2014 MH of AR) was implemented. In the control group, estrogen indices were studied in dynamics. Results. Pregnant women aged 35 years and older have an unfavorable background of extragenital and gynecological pathology that is confirmed by hormonal background. Conclusions. Planning of pregnancy, timely prevention and correction of clinicolaboratory indices permit to reduce the frequency and severity of pregnancy and delivery complications and improve the perinatal indices among patients of this age group.


2020 ◽  
Vol 16 (2) ◽  
pp. 12-21
Author(s):  
A. O. Soloviev ◽  
V. T. Dolgikh ◽  
O. N. Novichkova ◽  
N. V. Govorova ◽  
O. V. Leonov ◽  
...  

Purpose — to carry out a comparative assessment of inflammation based on evaluation of intraoperative and early postoperative dynamics of blood serum cytokines in pulmonary malignant neoplasm patients in different anesthesia and analgesia settings.Material and methods. 24 patients of 45 to 50 years of age divided into 2 groups were examined. All patients suffered from verified new onset malignant neoplasms without true signs of metastases. Tumor differentiation by morphology was not undertaken since that was beyond the study design. Patients did not receive radio- or chemotherapy. In Group I (the main group, n=12), a multimodal combined anesthesia [1] followed by extended postoperative epidural analgesia was applied. In Group II (the comparison group, n=12), a combined general anesthesia including mechanical lung ventilation followed by morphine analgesia was used. 4 study points were determined: prior to induction, and one, 12, and 24 hours post-surgery.Results. 12 hours after surgery completion, the concentration of TNFα in the main group was lesser by 57.1% vs. the comparison group; by the end of the first 24 hours, it fell down by 64.3%. Within the same period, in both groups IL-6 turned out to be significantly higher than the upper reference limit. By the end of the first 24 hours, IL-6 tend to decrease in both groups; however, in the comparison group, this parameter was 15% higher than in the main group. Serum IL-10 was within the reference range in both groups. One hour after surgery, concentrationof IL-10 was exponentially growing in both groups and exceeded multifold the upper reference limit, whereas the content of IL-10 in the main group remained reliably higher: the difference amounted to 35.6% percent.Conclusion. During the postoperative period, patients undergone lung resection displayed significant changes in cytokines concentrations demonstrating an inflammation reaction. Inflammation was significant in patients who received epidural analgesia as evidenced by an altered content of anti-inflammatory cytokines.


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