Biomedical subjects
Publications and source records attributed to V T Zaĭtsev.
In 56 patients with bleeding duodenal ulcer the influence of truncal, selective and selective proximal vagotomy on pancreatic blood flow was studied, basing on the intraoperative rheopancreatography data. The advantages of selective proximal vagotomy in correction of the disorders revealed were proved.
The results of performance of intraoperative rheopancreatography in 8 patients, operated on for an ulcer disease, were presented. The performance of selective proximal vagotomy and sympathectomy of a mesenterica superior had promoted the pancreatic blood flow improvement. It is substantiated in patients with secondary chronic pancreatitis, caused by the ulcer disease.
Characteristic changes of the cells were revealed while examination of 36 patients with an acute adhesional impassability of small intestine and of 14 healthy persons using electron-microscopic method of the peripheral blood lymphocytes studying. The authors consider the observed dystrophic nuclear changes, the nuclear membrane structure and mitochondrial architecture disorders, partial lysis of plasmatic membrane to be the morphological substrate of the intracellular power and the lymphocytes immunoactivity changes.
The results of the pancreatic gland (PG) blood flow was studied up in 121 patients with hemorrhage of different severity using intraoperative rheopancreatography. Under the influence of hemorrhage in the PG the arterial blood flow is lowering, the arteriovenous shunting mechanisms are starting.
The results of treatment of 51 patients with mediastinitis using mediastinal drain were summarized. Postoperative mortality was 15.7%.
The frequency of organ-preservation was raised up to 24%, the frequency of the purulent-inflammatory complications was lowered to 15.7% as well as mortality--to 11.7% during performance of operations on spleen due to application of the proposed individualized staged approach and new methods of hemostasis.
Comparative estimation of clinical course and postoperative complications was done in 134 patients, operated on for diffuse and generalized peritonitis, caused by anaerobic nonclostridial microorganisms in 74 (55.2%) of them and aerobic--in 60 (44.8%). More severe course and enhanced frequency of the peritonitis complications occurrence, caused by anaerobic microorganisms, was noted. The studying of characteristic peculiarities of peritonitis permits to perform purposeful antibacterial therapy even when bacteriological identification of initiating microorganism is impossible.
The data on the duodenal motor-evacuational function investigation in 62 patients with an ulcer bleeding are presented. It was established that the degree of duodenal chronic impassability is correlating with the degree of disorders of the gastric secretion intestinal phase. That's why it is necessary to stipulate the elimination of hyperchlorhydria in all phases of gastric secretion while such complication correction.
The condition was studied of bloodflow in 29 patients with duodenal ulcer, operated on because conservative therapy proved to be ineffective. In patients with uncomplicated duodenal ulcer, disorders of the pancreas bloodflow are at their greatest in the area of the head of the gland at the level of arterioles, with arteriolospasm phenomena being most noticeable. The secured data are to be taken account of in selection of therapeutic measures to be instituted in the patients.
The data concerning the disorder of the gastric secretion intestinal phase in patients with complicated forms of ulcer disease and with recurrent ulcer as well are presented. The mechanism was shown, which if noneliminated can cause nonfavourable result of the operation performed for the ulcer disease complications. The data presented trust the necessity of more meticulous studying of disorders of the gastric acidproducing intestinal phase in surgical gastroenterology.
The correction principles of enteral insufficiency, playing essential role in the infectional-toxical shock and polyorganic insufficiency occurrence were elaborated basing on the analyses of the surgical treatment of 257 patients with peritonitis and an acute ileus. Application of the proposed tactics of surgical aid for patients, including the original methods of the gut intubation, had permitted to lower the lethality from 30.2 to 18.5%, to improve the treatment results.
The increased risk factors--gender, age of the patient, the cholelithic disease existence duration, the acuteness of inflammation, the operations performed earlier on the abdominal cavity organs, influencing the laparoscopic cholecystectomy conduction for Courvoisier's gallbladder--were analyzed. The increase of intraoperative complications occurrence (hemorrhage, perforation of gallbladder, the outhepatic biliary ducts) in patients of elder age with durable disease was noted.
In 92 patients the influence of duodenostasis on possibility of occurrence of rehemorrhage from duodenal ulcer was studied. It was established that the heightened risk of rehemorrhage is promoted by disorders of motility, blood flow and acid production.
The results of treatment of 538 patients, operated on for perforative ulcer (PU), are studied up. Perforative aperture was sutured in 75 patients, in 153 the ulcer was excised, in 291 the excision was supplemented by vagotomy, resectional methods were applied in 19. In 94 (17.5%) of patients 114 complications have occurred after the operation. Postoperative complications were divided into those from the wound, in the abdominal cavity organs and retroperitoneal space, from the abdominal cavity, respiratory and cardiovascular system. After the operation 37 (6.9%) of patients have died. Complications and mortality were observed more frequently in the patients to whom the perforative aperture suturing and the ulcer excision with truncal or selective vagotomy were conducted in the presence of the increased operative risk (the elderly and senile age, concurrent diseases, widespread peritonitis). The least frequency of postoperative complications and mortality were noted after the PU and the ulcer substratum excision supplemented by selective proximal vagotomy.
Complex clinico-instrumental examination and surgical treatment of 172 patients with erosive-ulcerative changes of the gastroduodenal zone mucosa and atherosclerotic affection of aorta and main arteries was conducted. Functional peculiarities of erosive-ulcerative changes of the gastroduodenal zone mucosa in atherosclerosis of aorta and main arteries were revealed.
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Indications for the low-intensive laser application in preoperative procedure scheme were speculated on the ground of complex investigation data in 175 patients with gastrointestinal ulcerative hemorrhage (GIUH). Indications for intravascular laser blood irradiation (IVLBI), for the projectional action on thymus, spleen and their combined application are established. For the reliable hemostasis guarantee the conduction of laser therapy is the most effective one.