Biomedical subjects
Publications and source records attributed to N N Veligotskiĭ.
The results of application of constant vacuum extraction, a new method of the lower extremities trophic ulcers treatment, are adduced. There was shown the method efficacy in the treatment of the varicose disease complications, there were noted the reduction of the wound healing terms in comparison with such using conventional methods of treatment, the advantages and peculiarities of the method as well.
The state of the gastric mucosa regional blood flow and microcirculation in 148 patients with duodenal ulcer disease, complicated by sub-compensated or decompensated stenosis of gastric outlet, was studied. The lowering of indexes in various parts of stomach, along curvature minor especially, was revealed. These date substantiate the necessity of application of the organ-preserving operation with the ulcer excision and the dilating pyloroduodenoplasty performance in late stage of stenosis. If is recommended application of preparations, promoting normalization of the blood rheologic properties and mucosal microcirculation, for prophylaxis and the regional blood flow restoration in the early postoperative period.
The results of operative treatment of 126 patients with esophageal cancer, localized on different level, were analysed. In 73 of them the thoracic esophagus affection was revealed. Radical operations were performed in 46 and the palliative--in 27 patients. As a rule, one-staged esophagoplasty was done, using stomach and colon. The original method of the gastric transplant lengthening was proposed, permitting to perform one-staged retrosternal esophagoplasty with construction of cervical esophagogastroanastomosis. Complications have occurred in 6 patients.
Method of gastric wall tone determination before the operation in patients with gastroduodenal ulcer disease, complicated by pyloroduodenal stenosis (PDS) was elaborated. There were examined 86 patients with sub- and 62 with decompensated PDS using method of electrogastrography and of the intragastric pressure registration--using method of the opened catheter. Three degrees of the gastric motor function disorder were delineated. Tactics of treatment of such patients was elaborated.
The strict acceptance of the radicalism principles while the purulent inflammation origin eliminate, an accurate sanation and early placement of suture on the operation wound, its adequate and active drainage in combination with expedient local with the help of foamy aerosol "Dioxizol" and stable compensation of hyperglycemia, correction of the homeostasis disorders are necessary in the treatment of diabetes mellitus patients with local purulent-necrotic disease of the soft tissues.
The results of treatment of 259 patients with perforative duodenal ulcer, complicated by penetration and stenosis, were analysed. The original methods of ulcer excision are proposed. Excellent and good late follow-up result was noted in 159 (84.6%) patients, fair--in 15 (8.2%), bad (ulcer recurrence)--in 8 (4.4%).
The method of operative treatment of complicated duodenal ulcer disease consisting gastroduodenostomy, translocated by 3-4 cm medially and lower from the ulcer crater and strengthened by a spur on a small curvature side.
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The surgical treatment results of the hepatopancreatoduodenal zone cancer in the clinic from 1987 till 1992 are adduced. Of 91 operated patients in 31 of them the radical or conditionally radical operations were done. The modifications of their own of conventional methods were applied. Further improvement of the diagnosis methods is needed as well as the search of possibilities to augment the frequency of the radical operations accomplishment.
The experience with the use of the different methods of quantum hemotherapy in the treatment of elderly and senile patients with purulent-inflammatory diseases of the soft tissues has been summarized. Comparative characteristic of their effectiveness is presented. The authors consider the most expedient the use of intravascular quantum hemotherapy and combined methods.
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The complex study of the indices of local immune and natural resistance in the parietal mucus of the gastroduodenal zone and general immunity in 174 patients with duodenal ulcer disease before and after surgical treatment was performed. Pronounced suppression of local immunity, presence of autoimmune processes having influence on its indices were noted. After the organ-preserving operations with an ulcer excision, the immune indices restored more rapidly than after gastric resection and vagotomy without an ulcer excision.
Preservation of adequate blood supply to a gastric wall and resistance of mucosa of the gastroduodenal region with simultaneous full-value parasympathetic denervation of its acid-producing zone in performance of selective proximal vagotomy contributes to decrease in incidence and pronouncement of ischemic disorders in motor-evacuatory function of the stomach at the early postoperative period, effective and stable reduction in acid production, shortening of duration of the postoperative treatment and rehabilitation of the patients, prophylaxis of ulcer recurrences.
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A protective mucous barrier of the stomach was studied in 153 patients with duodenal ulcer disease. Before the operation in 70 patients, decrease in concentration of protective factors of gastric mucus, especially in complicated form of ulcer disease was noted. More complete restoration of a protective barrier was noted after organ-preserving operations with excision of ulcerous substrate (in 54 patients) than after those without its excision (in 29).