[Profuse bleeding caused by angio-digestive fistula].
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Biomedical subjects
Publications and source records attributed to V L Ermolaev.
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Emergency aid given to 1,258 persons with injury to the blood vessels is analysed. A new classification and 4 independent stages of emergency service are distinguished. An attempt is made to find common principles of organization of aid in time of peace and in time of war. The tactics in a combined vascular-nerve injury are substantiated, the indications for a tourniquet (18.3%) and temporary prostheses (16.9%) are suggested for reducing the incidence of postoperative complications, amputations, and mortality. The results of treatment (%): amputations, at the place of the accident 6.2, in the center 4.4, mortality 9.6 and 2.2, respectively. The percentage of purulent complications was similar--6.6.
Experience of treatment of 215 patients with obliterating diseases of the vessels in terminal stage using the method of transcatheter medicinal mixtures infusion was summarized. Use of original method permitted to avert the gangrene appearance in 65% of patients, to lower the amputation level--in 15%; in 20% of patients the result was unsatisfactory, high limb amputation was conducted to them.
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Under analysis were results of the treatment of 53 patients with severe ischemic states of lower extremities by the method of transcatheteral intraarterial infusions of drugs. Duration of the treatment was from 7 to 50 days. The composition of the mixtures was chosen individually. The method is found to be sufficiently effective when no radical intervention on the vessels is possible.
The analysis and systematization of errors and complications of punctures and catheterization of subclavian veins in 406 patients have been performed. Complications due to the technique of punctures and catheterization were recorded in 47 patients (11.6%). Complications appearing during using the catheter were noted in 46 patients (11.3%). In 6 patients (3.8%) examined in the late period there were symptoms of chronic venous insufficiency. In order to reduce the percentage of different complications the authors propose to use the puncture and catheterization only on the left side and on strict indications and by an experienced physician.
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Results of using temporary prostheses in 58 patients with different injuries of blood vessels are analyzed. Most often tubular materials were used for the prostheses. The authors consider that temporary prostheses must be used only in cases of a real threat of irreversible ischemia of extremities and when specialized angiosurgical aid is not possible within 4-6 hours and more.
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