The state of the gas exchange system was analyzed in 79 patients with a severe combined trauma (SCT) at the postshock period. It allowed detection of specific features of disturbances of the oxygen transport by blood in different kinds of injuries. The SCT with a critical injury of the brain is more often accompanied by hyperdynamia of circulation within the first two days after trauma, while the 3rd-4th days are characterized by a sharp drop of the heart index to (2,17 +/- 0,21) l/min.m2, oxygen transport to (261,9 +/- 37,2) ml/min.m2, oxygen consumption to (99,9 +/- 8,3) ml/min.m2. If the SCT was accompanied by a contusion of the heart the changes of central hemodynamics were especially pronounced and prolonged having a hypocirculatory character with a decreased cardiac and stroke index from the first hours of stay at the hospital (20,4 +/- 1,5) ml/m2 and (2,10 +/- 0,14) ml/min.m2 correspondingly. It led to a substantial decrease of indicators of the transport and consumption of oxygen correspondingly: (266,5 +/- 25,1) ml/min.m2 and (112,6 +/- 8,2) ml/min.m2. For the pathogenetically substantiated therapy of disturbances of the oxygen transport by blood the following measures are considered: isovolemic hemodilution, moderate sympathetic blockade, the use of membrane stabilizers, glucocorticoids, adrenolytics, solcoseryl. The state of the organism system of respiration and subsystem of the oxygen transport must be taken into consideration when choosing the optimum time for performing the postponed operative interventions at the postshock period.
Ninety patients with perforations and hemorrhaging duodenal ulcers were examined. It was established that the intragastric pH-metry in patients with acute complications of the ulcer disease allowed to approximately estimate the acid formation in the stomach and the completeness of vagotomy just in the course of urgent operations. The acid forming function of the stomach can be changed in 21,3% of the patients within the nearest 6 months.
The authors analyze the results of surgical treatment of 629 patients with acute ileus. In order to increase the diagnostic information value of the radiopaque dynamic investigation the authors propose to administer the liquid barium suspension through the probe introduced through the nose into the initial portion of the jejunum. It has been established that the level of content of the alkaline phosphatase intestinal fraction is an indirect index of the mesenterial blood circulation state. The experience of employment of visual angiometry for the assessment of vital capacity of the intestine and the size of its resection is described as well as other methods of decompression of the gastro-intestinal tract during the postoperative period.
A system including 10 factors of internal environment was developed on the basis of the EC-1022 computer-processed data on 389 cases of colonic cancer. Six of these factors proved to be of prognostic value. Graphs of probable prognosis of surgical treatment showed a direct correlation between the frequency of unfavorable results and importance of prognostically significant factors.
Under study were long-term results of the treatment of 356 patients with the syndrome of portal hypertension complicated by gastroesophageal bleedings. Various surgical interventions were performed on 147 of them. The authors made a conclusion that the selective "drainage" of the portal system (splenorenal anastomosis) had a number of advantages as compared with its total shunting.