Klinichna khirurhiia / Ministerstvo okhorony zdorov'ia Ukraïny, Naukove tovarystvo khirurhiv Ukraïny
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The results of a medical help delivery on prehospital stage to 200 injured persons, suffering penetrating abdominal wounding with hepatic damage, were analyzed. The main cause of death in 87.5% of the injured persons with open hepatic damage is a non-compensated blood loss, in 12.5%--traumatic shock and a prehospital stage duration. ⋯ Level of adequacy of the blood loss compensation have constituted in group of survivors--57.69%, and in the group of patients, who died--37.50%, what could not be considered satisfactory. In patients--survivors a conditional adequacy of application of hemostatics have constituted 76%, and in a group of the injured persons, who have died--0.
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Changes in the hemostasis system in choledocholithiasis, taking into account the obturation jaundice severity and possibility of the correction conduction, using miniinvasive operative interventions, were studied. Dynamic of changes in the hemostasis system in patients preoperatively, in 1 and 3 days after endoscopic papillosphincterotomy were monitored, using the method of a low--rate piezoelectric thromboelastography. Basing on analysis of the results, the changes in hemostasis in obturation jaundice were classified, taking into account its degree of severity, what have permitted to select a correct tactics for prophylaxis of hemorrhagic complications intraoperatively and postoperatively.