[Functional methods of the determination of time of surgical intervention in acute cholecystitis].
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Biomedical subjects
Publications and source records attributed to I A Ashimov.
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The effect of medical treatment on the peripheral mechanism of centralization of circulation and state of hepatic blood flow was studied. It is shown that inclusion of adrenoblocking agents in the complex of medical treatment of 98 patients with uncomplicated cholecystitis resulted on the second day in normalization of the renal blood flow, improved the condition of patients due to normalization of the reaction of centralization of the circulation.
On the day of operation for acute destructive cholecystitis functions of external ventilation prove to be disturbed due to deterioration of pulmonary blood flow (2-6 times) and ventilation (1.3-3 times). The degree of these disturbances are in direct dependence on the degree of the inflammatory process in gallbladder and time of preoperative observation. At the same terms after emergency cholecystectomy the lung functions were reestablished considerably quicker and was more valuable than after operations on urgent indications. Inclusion of adrenoblocking agents into conservative treatment of acute cholecystitis before and after operation facilitates more effective and quicker recovery of lung functions.
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The assessment of external respiration during a 2-day management of acute pain attack produced by cholecystitis disclosed a 1.2-1.5-fold decrease in the parameters of the function resultant from poor ventilation of the pulmonary zones and loss of coordination between the ventilation and relevant blood flow. On day 3 of the attack treatment of external respiration returned to normal functioning though in patients over 60 this return took a week, as they had a 1.2-2-fold drop in the blood flow and pulmonary ventilation. The attempts of administration of adrenoblockers in combined treatment of acute cholecystitis succeeded in restoration of pulmonary function during 3 days and in more rapid attenuation of attacks in acute cholecystitis.
By means of a method of rheography, in 74 patients with acute cholecystitis before and after the operation, and in 26 healthy subjects as well, the blood flow of the brain, lungs, liver and lower extremities under conditions of the use of benzohexamethonium, obsidan, aminazine and neostigmine methylsulfate was studied. Resulting from the use of sympathetic pharmacologic blockade, already by day 2, the indices of cerebral, pulmonary and hepatic blood flow normalized or exceeded the normal level.
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