RESUMEN
Results of combined treatment of 314 patients with acute pancreatitis, including 58 (15.1%) with pancreonecrosis were analyzed. Etiologic factors of acute pancreatitis were alcohol (59% patients), diseases of the bile ducts (31.5%), surgery (2.5%). Up-to-date diagnostic criteria of severe pancreatitis are presented, character of complications is analyzed. Treatment policy in acute edematous pancreatitis was conservative. In calculous cholecystitis cholecystectomy was performed after regress of acute pancreatitis. Fermentative ascitis-peritonitis was the indication for laparoscopy in aseptic phase of pancreonecrosis. US- and CT-guided puncture and drainage were often used. Surgeries were performed only for complications of pancreonecrosis, more often through mini-approaches. General lethality in acute pancreatitis was 1.9%, in pancreonecrosis - 10.7%, postoperative lethality in pancreonecrosis was 16.6%.
Asunto(s)
Pancreatitis/tratamiento farmacológico , Pancreatitis/cirugía , Enfermedad Aguda , Adulto , Colecistitis/etiología , Colecistitis/mortalidad , Terapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Pancreatitis/complicaciones , Pancreatitis Aguda Necrotizante/complicaciones , Pancreatitis Aguda Necrotizante/tratamiento farmacológico , Pancreatitis Aguda Necrotizante/cirugía , Peritonitis/etiología , Peritonitis/mortalidad , Resultado del TratamientoRESUMEN
A total of 127 male patients with obliterating atherosclerosis of lower limb arteries, stages I-IV, aged 43-76 years, were investigated. Thrombogenic potential in the blood from the upper, and lower limbs of patients was higher than in normal subjects, that was evidenced by elevation of blood platelet aggregation capacity, increased content of thrombocytic factor 4, fibrinogen concentration, and a rise in the level of soluble complexes of fibrin monomers. These changes were attended by the lowering of anticoagulant activity (a decrease in antithrombin III level) and fibrinolysis. The thrombogenic potential in the blood from the aorta was significantly higher than in the venous blood: increased intravascular spontaneous platelet aggregation, fibrinogen concentration, and significant rise in antithrombin III activity). Antithrombogenic potential of the vascular wall in patients is substantially lower as compared to that in normal subjects.
Asunto(s)
Aorta/fisiología , Arteriosclerosis/sangre , Hemostasis/fisiología , Pierna/irrigación sanguínea , Adulto , Anciano , Arterias , Humanos , Masculino , Persona de Mediana Edad , VenasRESUMEN
The article deals with a rather rare pathology of the 1st cervical vertebra (Kimmerle anomaly), which frequently may lead to rather serious, and sometimes hardly explicable changes in vertebrobasilar circulation. It is necessary to stress that practicing physicians have little information about this dysraphia and frequently cannot make its diagnosis. However, Kimmerle anomaly can be easily revealed almost at pre-hospital stage by the method of spondylography, which frequently resolves the tactics of treatment of a patient. It's important that the influence of such anomaly upon vertebrobasilar circulation can be verified by the method of angiography. In this case a subtraction digital angiography is used. This modern and highly informative method proves that the Kimmerle anomaly is the reason of the circulation disorders in brain stem of a patient.
Asunto(s)
Arteria Basilar/diagnóstico por imagen , Encéfalo/irrigación sanguínea , Vértebras Cervicales/anomalías , Arteria Vertebral/diagnóstico por imagen , Insuficiencia Vertebrobasilar/etiología , Angiografía de Substracción Digital , Vértebras Cervicales/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Síndrome , Insuficiencia Vertebrobasilar/diagnóstico por imagenRESUMEN
Examined were 156 patients (all the men) at the age of from 41 to 76 years with obliterative atherosclerosis of the arteries of the lower extremities. The antithrombogenic properties of a vascular wall were studied with a use of the functional vascular test with arteriovenous occlusion (cuff test). Reduction of the antithrombogenic properties of a vascular wall, ++anti-aggregative, anticoagulative and fibrinolytic activity as compared with those in normal subjects was revealed. For correction of disorders in antithrombogenic activity of a vascular wall, the administration of a complex of hemostatically active preparations (trental, phytin, glutaminic acid) is recommended.