Vestnik khirurgii imeni I. I. Grekova
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Vestn. Khir. Im. I. I. Grek. · Jan 1996
Comparative Study[The diagnosis and clinical assessment of the disseminated intravascular coagulation syndrome in complicated cancer of the gastrointestinal tract].
Under study were the state of the hemostasis system, the level of endogenous intoxication and anti-infectional defense in 63 patients with complicated carcinoma of the gastro-intestinal tract (GIT). It was established that the patients had the syndrome of disseminated intravascular coagulation (DIC) of blood which at first was of local character. Acute complications of carcinoma of GIT, first of all purulent peritonitis and profuse gastro-intestinal bleedings, aggravate endotoxicosis and facilitate the development of the acute DIC syndrome. A conception of the development of the intoxicative DIC syndrome is presented and proposed are informative methods of the assessment of hemostasis in emergency surgery of carcinoma of the GIT.
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Vestn. Khir. Im. I. I. Grek. · Jan 1996
Comparative Study[The surgical treatment of gunshot wounds].
The authors have made an analysis of results of clinical observations of 953 patients with gunshot wounds of soft tissues. It was found that primary surgical treatment (PST) of the gunshot wounds often proved to be not radical. ⋯ The indications for reoperations are as follows: the development of secondary necrosis of the tissues necessary removal of the foreign body, opening of the pockets and leaks in order to provide valuable drainage as well as nonradical PST due to various causes. Reoperations performed according to the indications allowed to make the duration of treatment at an average 7 days shorter and the development of suppurations two times less frequent.
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Under analysis is an experience with treatment of 187 patients with injuries to the spleen. Specific features of the clinical course, diagnostics and surgical methods are discussed. ⋯ Organ-saving operations were possible in 13% of the patients. Postoperative lethality was 3.7%.
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The authors have analyzed results of treatment of 170 patients with traumas of the liver and 129 patients with injuries of the spleen. It was established that the leading factors responsible for lethality were severity of shock, blood loss volume and the amount of associated injuries. The authors have shown that laser coagulation for hemostasis could reduce the amount of lethalities and gave less amount of postoperative complications.
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The results of 44 patients treatment with neck wounds are analysed. Isolated wounds of the neck were shown to be in 77.3%, combined trauma was determined in 22.7% of examination. ⋯ Postsurgical complications have developed in 6. The main reasons for complications occurred to be primary surgical wound treatment from little operative approach and noncomplete revision of the wound canal.