Vol 2, No 4 (2009)

Treatment results of 177 patients with acute pancreatitis were analysed according to endotoxicosis grade, blood serum amylase and myoglobin level on admission. Patients with I-grade endotoxicosis and moderate blood level of amylase and myoglobin underwent conservative treatment which resulted in early healing of the pancreatic inflammation. The operative activity of patients with II-grade of endotoxicosis made up 41,2 %. As a result of intensive therapy and laparoscopic abdominal lavage the pancreatic infiltrate became infected with significant rise of blood serum amylase and myoglobin level. There was no mortality in this group. Patients with III-grade endotoxicosis and very high level of blood serum myoglobin had disseminated chemical peritonitis with retroperitoneal abscesses and they had proper laparotomy. In this group there was a mortality of 54,5%. Therefore blood serum myoglobin has been shown to be a marker for tissue destruction.

Results of treatment 81 patients at the age from 19 till 78 years with phlegmons and abscesses of soft tissues are presented. Patients have been parted on 3 groups: 1 control 22 patients have made which treatment carried out in “the open way» by a drainage, daily sanations wound cavities a solution of a hypochlorite of sodium; 2 control - 25 patients which local treatment spent with application intracavitary programmed hydropressivno-aspiration sanations in conditions of “the closed contour»; the basic - 34 patients the complex program of medical actions at which consisted in carrying out intracavitary programmed gidropressivno-aspiratsionnoj the sanation added with ultrasonic influence. Application of a method of intracavitary hydropressivno-ultrasonic sanation has allowed to accelerate authentically terms of purification of wounds from is purulentnecrotic tissues, microbic bodies, to stimulate neogenesis processes, to improve cosmetic results of surgical treatment that in aggregate promoted reduction of terms of treatment and aftertreatment of the given contingent of patients.

Experiment on 20 not purebred dogs it is estimated haemostatic and reparative efficiency of biologically active granulated sorbents. In clinical section results of treatment of 539 patients with gastroduodenum bleedings of not ulcerative genesis from the top departments of a digestive tube are resulted. The developed program of the complex therapy including an endoscopic insufflation of biologically active granulated sorbents, a liquid diathermocoagulation, «balloon» applications of sorbents, application of inhibitors of a proton pomp, antagonists Í2-histaminic of receptors and antacids, antihelicobacter therapy allows to reduce quantity of relapses of a bleeding and immediate surgeries at bleeding height.

The article is devoted to new methods of conducting anthropometrical neck measurements reflecting its constitutional peculiarities (775 volonters). On the basis of the clinical (178 patients) and topographo-anatomical investigation (426 persons of boath sex groups) are studied the peculiarities of surgical anatomy of hypohyoid muscles, of thyroid and parathyroid glands structure as risk factors of making diagnostic mistakes and developing operative complications. A new approach is bein discussed for visualization of the recurrent laryngeal nerve in the operative procedures on neck organs.

Cholelithiasis refers to a number of widespread diseases which are usually treated by cholecystectomy. Some patients face the problem of postcholecystectomy syndrome after cholecystectomy. Up to the present day there is no generally accepted definition of this term, no unified classification reflecting concrete reason of pains and dyspepsia after cystectomy which will allow to choose adequate diagnostic and healing procedure.