The 8-th International Scientific Teleconference "Cardiovascular Surgery and Angiology - 2010"

Bulletin of the International Scientific Surgical Association, 2010, Vol. 5, N. 2-3

Russian version

Elongation of time of artificial blood circulation at ACBS promotes reduction of maintenance of IL-2 in blood serum of patients. The augmentation more than in 2 times of level of IL-8 in blood serum at patients after ACBS is registered, time of artificial blood circulation which was spent more than 3 hours. The augmentation of level of AGP in blood serum in the first days after ACBS at patients with longer time of artificial blood circulation is fixed. It is established, that the augmentation of time of artificial blood circulation substantially raises frequency of development of is purulent-septic complications.

The importance of the problem of women’s stroke in periclimacteric period in the medical and socio - epidemiological terms is discussed in this article. Epidemiological studies of stroke using the register method are carried out in Russia since 1972. Researches of a stroke with using territorially-population register weren't spent earlier in the Komi Republic. During the work on the basis of register data baseline morbidity and mortality from stroke among women of periclimacteric age are obtained, the structure of cases of acute cerebrovascular disorders and seasonal and regional distribution of disease in the Komi Republic are analyzed, the estimation of risk factors of development of acute cerebrovascular disorders is spent, the predominant clinical symptoms in the studied group are identified.

Due to the trophic alterations in the distal third of their legs and of the medial maleole, patients in C4, C5 and C6 stage of CVI according to CEAP are not suitable for conventional stripping. Incisions in zones with disrupted trophics should not be performed, because there is risk of delayed healing of the operative wound. Possible alternative to affect reflux on all levels and closure of trophic lesions remain the endovenous techniques and more specifically EVLT.

Analyzed are the results of EVLT on 23 cases, 14 of which are in C4 stage, 6 are in C5 stage and 3 are in C6 stage, 12-men and 11-women. The age was from 33 to 69 years.

In all these patients preoperatively incompetent valves of VSM in the calf segment was detected, as well as insufficiency of perforant veins. VSM has been exteriorized proximally over the trophic changes and ante- and retrograde laser ablation has been performed.

There were no complications in the early postoperative period.

During the first 2 months after the operation in 3 patients in C6 stage was observed healing of the trophic ulcer, in the other patients there was significant improvement of the cutaneous perfusion.

There were no relapses 1-to 3 years after the procedure.

The use of ЕVLT in patients with trophic skin alterations proves to be efficient method for treatment of CVI.

The 25 patients with cerebrovascular diseases are inspected in a republican neurological separation. The patients received traditional vascular, neurometabolic therapy. The 15 persons received Cavintonum as a part of complex therapy, 10 - made control group. Meaningful prevalence of women in all groups of patients is marked. Persons with a chronic ischemia of a brain of second degree prevailed among survey samples of patients. The decline of indexes of insomnia is exposed after the course of therapy. The indexes of depression and the indexes of anxiety decreased. Among with the positive dynamics of time of reproduction the numbers, the indexes of brief memory did not change.

The aim of the work was to evaluate the information content of a series of biochemical indicators in the acute period of stroke to determine the prognosis of the dynamics of the patient. High blood glucose levels above 6.1 mmol / l, levels of total protein of blood plasma is less than 65 g / l, blood cholesterol levels increases above 6.0 mmol / l on admission – theese signs are the most informative for the prediction of negative neurological dynamics. Significant information value to determine the prognosis of moderate positive dynamics of stroke possessed the increase of phenylalanine level above 115 umol / L, increase of tyrosine level above 83 umol / L. Border informativity was determined for reducing of the total protein of blood plasma. When is less than 65 g / l at the time of admission for this group of patients. Normal value of serum tryptophan possess informativity to determine the favorable dynamics in the treatment process. Value of Fisher index between 3-3,5 did not have informativity to determine the significant reduction in neurological deficit. Indicators of increased creatinine blood plasma are not highly informative for the prognosis of the disease.

We analyzed data on all cases of hospitalization of patients with myasthenia gravis in the neurological department. We found that the decline in the quality of life in patients with myasthenia largely due not only to muscle weakness due to potentially kurabelnogodisease, but also its attendant emotional disorders, coupled with the perception of the disease.

In this study the frequency, clinical manifestations, risk factors and preventive measures of drug-eluting coronary stents thrombosis in a long-term period were identified. All 1238 patients with clinical manifestations of ischemic heart disease (angina pectoris, excercise intolerance) have received conservative therapy, they have undergone complex noninvasive examination and coronarography. Сoronary stents «Sypher» with sirolimus and «Taxus» with paclitaxel have been implanted. Double antiplatelet therapy, which consists of combination of acetylsalicinic acid with clopidogrel had been prescribed for each patient.

An investigation has been done in 105 patients with the syndrome of diabetic foot (DF) (50 patients presenting the main group and 55 patients presenting the reference group) with the aim of evaluation the influence of a hydrotul ointment bandage Hydrotul on skin graft engrafting and epithelization speed of the donor area. In the main group Hydrotul was applied to a transplant or to the donor area, in the reference group a sterile cotton mesh was applied to a transplant, and the donor area was covered by an aseptic bandage.It has turned out to be that in case of using a hydrogel gauze bandage 'Hydrotul" in the main group percentage of engraftment and epithelization of the donor area has been trustworthy increased.

In 8 laser ablations combined with crossectomy or phlebectomy, a segment of VSM, treated with laser energy, has been removed and subsequently examined histologically.

The histologic investigation show thermodamage with crater-shaped defects, carbonization and endothelium destruction, vacuolization of the subendothelial layer and partial coagulation necrosis and carbonization of the medium where the venous wall has been in contact with the laser fiber.

The performed macro- and microscopic investigations give us reason to rely on effective laser coagulation of varicose veins and stable postoperative result accordingly.