Vol 5, No 2 (2012)

With the years there is a structural both functional disadaptation and the organization of systems an organism. The great
influence on the given process renders number of accompanying diseases. Their cumulative effect reaches a maximum at
advanced age, doing traditional methods of surgical treatment by the extremely risky. For an estimation of operational risk
classification МНОАР(1989) with definition of degree of risk during all periods of surgical treatment is modified: presurgical,
intraoperative and postoperative. Calculation of indicators of risk of 111 patients at the age from 45 till 89 years which have
been hospitalized in a surgical hospital concerning an acute calculous destructive cholecystitis is made. By the given patient it
was spent two principal views of interventions: a traditional cholecystectomia and maloinvazive technologies. The age doesn't
render authentic influence on differences of operational-anesthesiology risk. Performance of a traditional cholecystectomia
is bound to high operational-anesthesiology risk during an operational intervention. Application maloinvazive methods of
treatment of an acute calculous cholecystitis allows to lower risk and to improve results of treatment

Assessed the function of external breath and state value of the tracheobronchial tree in 50 patients with cholelithiasis
on the basis of the results of spirometry and bronchoscopy. Researches were performed before and 3-5 days
after cholecystectomy performed by mini - invasive techniques. Infringements of function of external breath were detected
before operation in 42 (84, 0 %) patients, thus prevailed restrictive disorders - 97, 6 %. Changes in the tracheobronchial
tree were found in 39 (78.0%) patients. In the early postoperative period observed negative dynamics of parameters of
function of external breath and bronchoscopic picture. The specified changes were characterized by an increase of frequency
of revealing "active" endobronchitis from 66, 0 % to 86, 5 % (р=0, 05) and increase of obstructive disorders of function of
external breath from 52, 0 % to 74, 0 % (р=0, 04) which development is not caused by a painful syndrome and restriction of
diaphragm mobility

Acute adhesive intestinal obstruction is the most serious late postoperative complication. Postoperative mortality in violation
of passage of intestinal contents, caused by adhesions formed as high as 15%. The structure of urgent surgical pathology
adhesive ileus is a leader. According to the literature, the implementation of minimally invasive interventions, the perfection
of suture material and so should reduce the number of patients with this postoperative complication. The paper presents an
analysis of patient diagnosed with acute intestinal obstruction admitted to the surgical department of Belgorod City Clinical
Hospital. Studied medical history, condition at admission, clinical manifestations of acute adhesive intestinal obstruction,
evaluated the diagnostic possibilities of instrumental methods of examination. Shows the dynamics of referral of patients for
the years analyzed, as well as the tactics of treatment and outcome of disease.

The results of the treatment of 118 patients with chronic complications of the ulcer disease were studied. 1 group- 60 patients
operated with chronic complications of the ulcer disease without correction of the motility of the duodenum. 2 group – 58
patients operated with chronic complications of the ulcer disease and correction of the chronic duodenal obstruction was
done. Morphologic investigation of the stomach and duodenal mucous membrane showed that after conservative or surgical
correction of the chronic duodenal obstruction in patients with chronic complications of the ulcer disease signs of disturbed
secretion, protection function and endocrinopathy were removed.

The aim of the study was a comparative evaluation of the effectiveness of distinct prevention of abdominal adhesions after
intravenous, subcutaneous and intraoperative paravasal routes of administration of heparin in conditions of ischemic injury
of the small intestine. The paper presents an experimental study conducted on 40 adult mongrel dogs were divided into 4
groups (10 dogs in each group). The first group formed the stomach in kind, which was not carried out heparin, the second
- the animals, which the eye was performed, intravenous heparin, and the third - the animals, which produced subcutaneous
heparin and the fourth - of animals, which was carried out intraoperative heparin in the tissue of a neurovascular beam
mesentery. From the venous vessel, directly adjacent to the ischemic area of the small intestine 20 minutes after creating
the model for the fracture circulatory organs are made to draw blood with subsequent study of several coagulation-analytic
system of blood: clotting time by Lee-White, prothrombin time and prothrombin ratio, the activity of antithrombin III.
After taking the blood from the venous vessel last tied. Then, the surgical wound sutured in layers. Postoperatively, any
treatment of animals was conducted. At various times after surgery were evaluated functional and morphological changes in
the experimental section of the intestine. Based on the data shown conclusive advantages of intraoperative paravasal the set
route of administration of heparin in the prevention of abdominal adhesions.

On a base analysis of results treatment 118 patients with acute pyoinflammatory diseases of skin and subcutaneous soft
tissues is fulfilled comparison of three modes treatment primary purulent wounds: with Perftoran, by traditional way and
with ozonized Perftoran. It were studied physic-chemical features of Perftoran administered for local application before and
after ozonizing. The revealed changes dispersed composition Perftoran not led to a decrease in efficiency in the use of this
drug. It was found out that treating purulent wounds with Perftoran and combination Perftoran and ozone have advantages
over traditional way of treatment and clinical effectiveness ozonized Perftoran is higher than clean preparation. Using for
purulent wound treatment ozonized Perftoran resulted in notable decreasing of patient’s treatment duration

In structure of proctological diseases the epithelzed pilonidal sinus (EP) took fourth place. Choosing the wrong medical
tactics and method of operation lead to complications and associated diseases in 6-30%, suppuration and diseases in chronic
form of the 10-30% operated. To improve the results of surgical treatment in patients with different stages of disease EP
proposed the differential approach to a choice of method of treatment. Under supervision were 230 patient at the age from
17 to 53 years. The control group (I) was made by 102 patient operated by a traditional technique. The basic group included
128 patients. In this group the method of a choice of operative treatment and a variant of closing of a wound depended on
prevalence of inflammatory process and topografo-anatomical fiatures cluneal-coccygeal area. Wound closing was carried
out intracutaneous sutures. In the first group of 19 (18.6%) patients had postoperative complications. In the second group the
complicated current was marked only at 6 (4.7%) patients. Disease relapses have arisen at 11 (10.8%) patients control group
and 1(0.8%) patient of the basic group

The actual work presents the results of using various programs of nutrition support for patients with severe nontraumatic
intracranial hemorrhage. The huge reduction of both cellular and humoral immunity is established in the first day of the
onset of the disease. The authors assess the impact of the combined enteral-parenteral nutritive support with dipeptide
alanine-glutamine on immune rates and severity of nutrition deficiency. The work deals with the comparative characteristics
of complications of these nutrition programs. It is established, that application of alanine-glutamine in complex intensive
therapy reduces the frequency of pneumonia, delays pneumonia development, reduces the duration of mechanical ventilation
and the time of ICU stay.

Morphological investigation of reclaim generated after the replacement of postresectional defects of the pericardium,
diaphragm and the thoracic wall using implant of nanostructural nickelid-titan suture was studied. The newly formed
tissue intergrows the implant mass, thus forming the entity of regenerative tissue, which provides anatomic and physiologic
reconstruction of the injured area

The morphometric topography and gistotoporaphy of bladder, vesico-urethral connection, in 85 of the dead child, a young,
first-and second mature age periods. In 33 of the dead people of the first and second mature age periods studied morphometric
topography and gistotopography of the prostate gland. The study was carried out of prostatoptosis the first and the second
degree in the process of treating the symptoms of the violation of urination “of per rectum” massage of the prostate gland
and physiotherapy exercises, directed on the joints and bone-muscular machines belt of the lower extremity. The suggestion
was made on the introduction into the list of diseases of the prostate gland this nosology as “prostatoptosis— descent of the
prostate gland”. There are physical signs of this disease.