K. Rustemova, S. Kozhakhmetov, S. Saparbaev, A. Ismatov, N. Tursynbaev, S. Zhylkaidar
Treatment of complicated forms of purulent wounds is an actual problem of modern medicine. A serious problem of the preoperative period is purulent complications that develop in 15-35% of cases, mortality reaches 25-60%. It is known that the predominant pathological syndrome in complicated forms of purulent sepsis is the syndrome of endogenous intoxication (SEI). Objective. In this regard, the desire of many researchers to study new methods of intensive care for the syndrome of endogenous intoxication is understandable [1,2,3,4,5,5,6,7,8]. The authors analyzed the effectiveness of the use of mediators (surfactant) of fetal hepatocytes in the complex treatment of purulent-septic wounds. Material and methods. A prospective study method was carried out for the main group, which consisted of patients with purulent-septic wounds (PSW) - 50 people, in the complex treatment of which cellular mediators (CM) were used; control group - 50 patients with PSW treated according to the traditional scheme. Results. The results of treatment with cellular mediators were evaluated in 50 patients who received this drug at a dose of 0.15 ml/kg. The control group consisted of 50 patients who received saline at a dose of 0.15 ml/kg as a placebo. Men 27, women 23. The study was conducted in accordance with the Clinical Protocol for Surgical and Diagnostic Intervention of Transplantation of Fetal Cell Mediators Recommended by the Expert Council of the RSE on REM «Republican Center for Health Development» of the Ministry of Health and Social Development of the Republic of Kazakhstan dated September 30, 2015 (Protocol №. 10). Conclusion. The results of the study have been implemented in the practice of the PKP on the REM of the Nur-Sultan MCH №2 and the Nur-Sultan MCH №1 ; highlighted in the work of the poster session of the VII Congress of Surgeons of Kazakhstan with international participation in Almaty from 30.09.-01.10.2021. Received AC No. 18079 of the Republic of Kazakhstan dated May 27, 2021 (www. kazpatent.kz)
{"title":"THE USE OF CELLULAR TECHNOLOGIES IN THE COMPLEX TREATMENT OF PURULENT-SEPTIC WOUNDS","authors":"K. Rustemova, S. Kozhakhmetov, S. Saparbaev, A. Ismatov, N. Tursynbaev, S. Zhylkaidar","doi":"10.35805/bsk2022i039","DOIUrl":"https://doi.org/10.35805/bsk2022i039","url":null,"abstract":"Treatment of complicated forms of purulent wounds is an actual problem of modern medicine. A serious problem of the preoperative period is purulent complications that develop in 15-35% of cases, mortality reaches 25-60%. It is known that the predominant pathological syndrome in complicated forms of purulent sepsis is the syndrome of endogenous intoxication (SEI). Objective. In this regard, the desire of many researchers to study new methods of intensive care for the syndrome of endogenous intoxication is understandable [1,2,3,4,5,5,6,7,8]. The authors analyzed the effectiveness of the use of mediators (surfactant) of fetal hepatocytes in the complex treatment of purulent-septic wounds. Material and methods. A prospective study method was carried out for the main group, which consisted of patients with purulent-septic wounds (PSW) - 50 people, in the complex treatment of which cellular mediators (CM) were used; control group - 50 patients with PSW treated according to the traditional scheme. Results. The results of treatment with cellular mediators were evaluated in 50 patients who received this drug at a dose of 0.15 ml/kg. The control group consisted of 50 patients who received saline at a dose of 0.15 ml/kg as a placebo. Men 27, women 23. The study was conducted in accordance with the Clinical Protocol for Surgical and Diagnostic Intervention of Transplantation of Fetal Cell Mediators Recommended by the Expert Council of the RSE on REM «Republican Center for Health Development» of the Ministry of Health and Social Development of the Republic of Kazakhstan dated September 30, 2015 (Protocol №. 10). Conclusion. The results of the study have been implemented in the practice of the PKP on the REM of the Nur-Sultan MCH №2 and the Nur-Sultan MCH №1 ; highlighted in the work of the poster session of the VII Congress of Surgeons of Kazakhstan with international participation in Almaty from 30.09.-01.10.2021. Received AC No. 18079 of the Republic of Kazakhstan dated May 27, 2021 (www. kazpatent.kz)","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127055929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zh. Chyngysheva, E. Tilekov, D. Turdusheva, U. Turdiev, D. Nazarbekov, A. Kubanychbekova
Objective. An analysis of the study, in the mode of fast and slow blood exfusion, controlled clinical trials showed that the number of platelets was significantly reduced. Material and methods. We have conducted a series of researches in 44 patients with cavitary blood loss, which is 34.3% of the total number of the examined patients (n-128), for whom an IOBR apparatus technology was used. The studies were also conducted during the surgery in the first 2 hours. Results. Controlled clinical trials (CCT) have shown that blood exfusion after intraoperative blood reinfusion, the degree of destruction of erythrocytes and leukocytes with slow blood exfusion is 35%, and with fast - 48%. Osmotic resistance is reduced by 3 times. With rapid hardware exfusion, blood hemolysis is more than 28%, which should be taken into account when performing hardware intraoperative blood reinfusion. Controlled clinical trials have shown that the faster the machine exfusion is performed, the greater the decrease in protein and bilirubin content. In the blood collected in the mode of rapid apparatus exfusion, a higher concentration of K +, residual N and urea is noted. Controlled clinical trials have shown that platelet counts are significantly reduced, especially when using a rapid blood collection regimen. Against this background, the process of aggregation is reliably slowed down, and with a fast mode of blood collection - 2 times in comparison with the control. Plasma recalcification time is reliably reduced by 40% when using a high-speed blood collection mode in comparison with the control values, which is almost 3 times higher than when using slow blood aspiration. Conclusion. The article provides an analysis of scientific research, CCT, experimental control, clinical control and practical work. The work is interdisciplinary in nature, written at the intersection of surgery and anesthesiology, to increase the effectiveness of emergency surgery and anesthesiologyresuscitation in critical abdominal and luminal blood loss based on the optimization of intraoperative infusion-transfusion therapy
{"title":"COMPARATIVE EVALUATION OF A CONTROLLED CLINICAL TEST OF APPARATUS INTRAOPERATIVE REINFUSION OF BLOOD COLLECTED FROM THE PLEURAL CAVITY UNDER SLOW AND FAST MODES","authors":"Zh. Chyngysheva, E. Tilekov, D. Turdusheva, U. Turdiev, D. Nazarbekov, A. Kubanychbekova","doi":"10.35805/bsk2022i031","DOIUrl":"https://doi.org/10.35805/bsk2022i031","url":null,"abstract":"Objective. An analysis of the study, in the mode of fast and slow blood exfusion, controlled clinical trials showed that the number of platelets was significantly reduced. Material and methods. We have conducted a series of researches in 44 patients with cavitary blood loss, which is 34.3% of the total number of the examined patients (n-128), for whom an IOBR apparatus technology was used. The studies were also conducted during the surgery in the first 2 hours. Results. Controlled clinical trials (CCT) have shown that blood exfusion after intraoperative blood reinfusion, the degree of destruction of erythrocytes and leukocytes with slow blood exfusion is 35%, and with fast - 48%. Osmotic resistance is reduced by 3 times. With rapid hardware exfusion, blood hemolysis is more than 28%, which should be taken into account when performing hardware intraoperative blood reinfusion. Controlled clinical trials have shown that the faster the machine exfusion is performed, the greater the decrease in protein and bilirubin content. In the blood collected in the mode of rapid apparatus exfusion, a higher concentration of K +, residual N and urea is noted. Controlled clinical trials have shown that platelet counts are significantly reduced, especially when using a rapid blood collection regimen. Against this background, the process of aggregation is reliably slowed down, and with a fast mode of blood collection - 2 times in comparison with the control. Plasma recalcification time is reliably reduced by 40% when using a high-speed blood collection mode in comparison with the control values, which is almost 3 times higher than when using slow blood aspiration. Conclusion. The article provides an analysis of scientific research, CCT, experimental control, clinical control and practical work. The work is interdisciplinary in nature, written at the intersection of surgery and anesthesiology, to increase the effectiveness of emergency surgery and anesthesiologyresuscitation in critical abdominal and luminal blood loss based on the optimization of intraoperative infusion-transfusion therapy","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128144821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepaticojejunostomy stricture is the disastrous complication of biliary surgery, if untreated can lead to intrahepatic stones, recurrent cholangitis, biliary cirrhosis and hepatic faiulure. Here, we report a case with the one-more year history of recurrent cholangitis, caused by late stricture of hepaticojejunal anastomosis after iatrogenic bile duct injury
{"title":"TREATMENT OF LATE STRICTURE OF HEPATICOJEJUNAL ANASTOMOSIS AFTER POST-CHOLECYSTECTOMY BILE DUCT INJURIES","authors":"Surkhay Gadiyev, A. Asadova","doi":"10.35805/bsk2022i006","DOIUrl":"https://doi.org/10.35805/bsk2022i006","url":null,"abstract":"Hepaticojejunostomy stricture is the disastrous complication of biliary surgery, if untreated can lead to intrahepatic stones, recurrent cholangitis, biliary cirrhosis and hepatic faiulure. Here, we report a case with the one-more year history of recurrent cholangitis, caused by late stricture of hepaticojejunal anastomosis after iatrogenic bile duct injury","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123831106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Maylybaev, Ardak Ainakulov, D. Zharasov, Zh. Imanberdiev, B. Abdimazhitov, A. Taszhurekov, G. Kuttumuratov, A. Mirmanov
Material and methods. The study is based on the results of diagnosis and treatment of 444 children with congenital obstructive diseases of the urinary tract. They were in the urology department of NRCMCH since August 2007. To differentiate organic and functional obstructive uropathy were conducted high-tech, informative and noninvasive imaging diagnostic methods. On the basis of which were provided a differentiated treatment. Results. Children with functional hydronephrosis and vesico-dependent version of urodynamic disorders in obstructive megauretera received conservative treatment. In ureteral type of the functional form of obstructive megauretera and 2-3 stage of vesicoureteral reflux were provided mini invasive endoscopic treatment. Effectiveness of endoscopic treatment of obstructive megauretera was - 85%, while the vesicoureteral reflux of 2nd stage - 100%, grade 3 - 80%. The use of mini lumbotomy frontside access for hydronephrosis, allowed towork locally in the area of ureteropelvic segment, to avoid injury of the kidneys and paranephritis. Conclusion. Thus, the use of an integrated approach to diagnosis using minimally invasive, highly informative methods made it possible to pathogenetically substantiate the choice of tactics for the treatment of obstructive uropathy in children and significantly improve the results of this complex category of patients.
{"title":"DIAGNOSIS AND TREATMENT OF OBSTRUCTIVE UROPATHY IN CHILDREN","authors":"B. Maylybaev, Ardak Ainakulov, D. Zharasov, Zh. Imanberdiev, B. Abdimazhitov, A. Taszhurekov, G. Kuttumuratov, A. Mirmanov","doi":"10.35805/bsk2022i016","DOIUrl":"https://doi.org/10.35805/bsk2022i016","url":null,"abstract":"Material and methods. The study is based on the results of diagnosis and treatment of 444 children with congenital obstructive diseases of the urinary tract. They were in the urology department of NRCMCH since August 2007. To differentiate organic and functional obstructive uropathy were conducted high-tech, informative and noninvasive imaging diagnostic methods. On the basis of which were provided a differentiated treatment. Results. Children with functional hydronephrosis and vesico-dependent version of urodynamic disorders in obstructive megauretera received conservative treatment. In ureteral type of the functional form of obstructive megauretera and 2-3 stage of vesicoureteral reflux were provided mini invasive endoscopic treatment. Effectiveness of endoscopic treatment of obstructive megauretera was - 85%, while the vesicoureteral reflux of 2nd stage - 100%, grade 3 - 80%. The use of mini lumbotomy frontside access for hydronephrosis, allowed towork locally in the area of ureteropelvic segment, to avoid injury of the kidneys and paranephritis. Conclusion. Thus, the use of an integrated approach to diagnosis using minimally invasive, highly informative methods made it possible to pathogenetically substantiate the choice of tactics for the treatment of obstructive uropathy in children and significantly improve the results of this complex category of patients.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127298589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Ormanov, E. Abilkhanov, I. Azizullayev, A. Sapunov, A. Kudaibergen
Coronary arteriovenous fistula (CAF) is a rare form of congenital heart disease. However, it is the most common type of congenital anomaly of the coronary arteries. [1] When there is the connection between the coronary artery and the chambers of the heart, it is called a coronary chamber fistula. The fistula may also be between a coronary artery and another adjacent vessel from the pulmonary or systemic circulation. An open fistula provides low-resistance flow by directing blood from an artery into a vein, heart chamber, or other low-pressure vessel such as the pulmonary artery. Patients with CAF may develop symptoms at birth or later in life, depending on the type of fistula and the presence of collateral circulation. Studies have reported an association between ventricular arrhythmias and sudden cardiac death syndromes in young adults and athletes with certain types of coronary anomalies, such as anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) [2-5]. The most common symptom is a myocardial ischemia. The purpose of this article is to present a clinical case of endovascular treatment of coronary pulmonary fistula. As a result of a modern diagnostic methods, such as CT angiography with three-dimensional reconstruction, it is not difficult to assess the degree and nature of the pathology. Having assessed the tactics, modern doctors are able to cope with coronary arteriovenous fistulas with great success using minimally invasive X-ray endovascular technologies.
{"title":"CORONARY PULMONARY FISTULA","authors":"B. Ormanov, E. Abilkhanov, I. Azizullayev, A. Sapunov, A. Kudaibergen","doi":"10.35805/bsk2022i044","DOIUrl":"https://doi.org/10.35805/bsk2022i044","url":null,"abstract":"Coronary arteriovenous fistula (CAF) is a rare form of congenital heart disease. However, it is the most common type of congenital anomaly of the coronary arteries. [1] When there is the connection between the coronary artery and the chambers of the heart, it is called a coronary chamber fistula. The fistula may also be between a coronary artery and another adjacent vessel from the pulmonary or systemic circulation. An open fistula provides low-resistance flow by directing blood from an artery into a vein, heart chamber, or other low-pressure vessel such as the pulmonary artery. Patients with CAF may develop symptoms at birth or later in life, depending on the type of fistula and the presence of collateral circulation. Studies have reported an association between ventricular arrhythmias and sudden cardiac death syndromes in young adults and athletes with certain types of coronary anomalies, such as anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) [2-5]. The most common symptom is a myocardial ischemia. The purpose of this article is to present a clinical case of endovascular treatment of coronary pulmonary fistula. As a result of a modern diagnostic methods, such as CT angiography with three-dimensional reconstruction, it is not difficult to assess the degree and nature of the pathology. Having assessed the tactics, modern doctors are able to cope with coronary arteriovenous fistulas with great success using minimally invasive X-ray endovascular technologies.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131072763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Issamatov, T. Tajibaev, E. Yenin, R. Khassanov, S. Omar, A. Umutbayeva, D. Zhagypar, U. Medeubekov
Hepatocellular carcinoma (HCC) is a malignant tumor of the liver which accounts for up to 90% of all liver cancers. In recent years, there has been an increase in the incidence of HCC all over the world, including in Kazakhstan. Diagnostic issues are still important. Alpha-fetoprotein (AFP) is a specific marker most widely used in the diagnosis of HCC. The article describes of the features of the AFP expression level in immunohistochemical studies with different stages and gradation of hepatocellular carcinoma, as well as a correlation analysis with serum AFP. Material and methods. A total of 50 patients with HCC were analyzed. Blood serum tests were performed to determine the level of AFP and an IHC study to assess the expression of AFP. Results. When analyzing the serological AFP, it was found that in the vast majority of cases (n=33), values were between 10-20 units/ml. In 83% cases HCC, cytoplasmic and nuclear expression of AFP was determined in malignant cells in IHC. The expression of the AFP was high in 32% cases, moderate in 46% cases, and low or not detected in 22% cases. The area of AFP - immunopositive cells node averaged 37.25±15.47%. When conducting a correlation analysis, it was found that the overall Pearson correlation coefficient between serum AFP and the degree of AFP staining was r = +0.0089. Conclusion. Critically high AFP values correlate with the degree of HCC differentiation. The results of IHC showed that in 83% of patients with HCC, cytoplasmic and nuclear expression of AFP, which indicates a high sensitivity of the marker regarding the definition of malignancy. Given the absence of a correlation, it can be assumed that the serum AFP value cannot be associated with AFP expression data in immunohistochemistry and can be used as a separate value for HCC differentiation
{"title":"FEATURES OF AFP EXPRESSION LEVEL AT DIFFERENT STAGES AND GRADATIONS OF HCC, CORRELATION ANALYSIS BETWEEN SERUM AFP","authors":"B. Issamatov, T. Tajibaev, E. Yenin, R. Khassanov, S. Omar, A. Umutbayeva, D. Zhagypar, U. Medeubekov","doi":"10.35805/bsk2022i049","DOIUrl":"https://doi.org/10.35805/bsk2022i049","url":null,"abstract":"Hepatocellular carcinoma (HCC) is a malignant tumor of the liver which accounts for up to 90% of all liver cancers. In recent years, there has been an increase in the incidence of HCC all over the world, including in Kazakhstan. Diagnostic issues are still important. Alpha-fetoprotein (AFP) is a specific marker most widely used in the diagnosis of HCC. The article describes of the features of the AFP expression level in immunohistochemical studies with different stages and gradation of hepatocellular carcinoma, as well as a correlation analysis with serum AFP. Material and methods. A total of 50 patients with HCC were analyzed. Blood serum tests were performed to determine the level of AFP and an IHC study to assess the expression of AFP. Results. When analyzing the serological AFP, it was found that in the vast majority of cases (n=33), values were between 10-20 units/ml. In 83% cases HCC, cytoplasmic and nuclear expression of AFP was determined in malignant cells in IHC. The expression of the AFP was high in 32% cases, moderate in 46% cases, and low or not detected in 22% cases. The area of AFP - immunopositive cells node averaged 37.25±15.47%. When conducting a correlation analysis, it was found that the overall Pearson correlation coefficient between serum AFP and the degree of AFP staining was r = +0.0089. Conclusion. Critically high AFP values correlate with the degree of HCC differentiation. The results of IHC showed that in 83% of patients with HCC, cytoplasmic and nuclear expression of AFP, which indicates a high sensitivity of the marker regarding the definition of malignancy. Given the absence of a correlation, it can be assumed that the serum AFP value cannot be associated with AFP expression data in immunohistochemistry and can be used as a separate value for HCC differentiation","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132735310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kozhakhmetov, K. Rustemova, N. Igisinov, Olzhas Akyshev, Abzal Ismatov, I. Sagatov, B. Aitmoldin, Zhomart Zhalgasbaev
Objective. To improve the results of endovideosurgical treatment of patients with acute destructive pancreatitis. Material and methods. The research was carried out at the bases of the Nur-Sultan Multifunctional City Hospital №2 and the Nur-Sultan Multifunctional City Hospital №1. Statistical analysis of the results was carried out using the methods of variation statistics with the calculation of M ± SD. Differences between comparison groups were analyzed using the Wilcoxon-Man-Whitney test and were considered statistically significant at p≤ 0.05. From 2017-2021, 64 patients with acute destructive pancreatitis were treated according to the developed and implemented treatment algorithm: Of these: AP without organ failure and local or systemic complications -10 people. AP of moderate and severe form -54 people. Lethal outcomes-1; The average length of stay in the hospital is 20.8±1.2 days; The mean age was 43 ± 1.3 years. The control group - treatment of patients with moderate and severe acute biliary pancreatitis without the use of ulinostatin (hereinafter US) was n = 122; Lethal outcomes-8. An algorithm for the use of US was developed and implemented depending on the severity of the course of destructive pancreatitis in the complex treatment of patients with AP. Results. 10 patients were treated conservatively. 54 - surgical treatment was combined with the appointment of US according to the developed scheme. Endoscopic surgery was performed in 51 patients; 3 patients were operated on by laparotomy. The average duration of hospital stay in the main group was 3.5±0.34 days less than in the control group. Conclusion. The research results showed the high efficiency of the developed algorithm for endovideosurgical treatment of AP in combination with the use of the US. Received AC №14704 dated January 27, 2021 (www.kazpatent.kz).
{"title":"MODERN PRINCIPLES OF TREATMENT OF ACUTE DESTRUCTIVE PANCREATITIS","authors":"S. Kozhakhmetov, K. Rustemova, N. Igisinov, Olzhas Akyshev, Abzal Ismatov, I. Sagatov, B. Aitmoldin, Zhomart Zhalgasbaev","doi":"10.35805/bsk2022i011","DOIUrl":"https://doi.org/10.35805/bsk2022i011","url":null,"abstract":"Objective. To improve the results of endovideosurgical treatment of patients with acute destructive pancreatitis. Material and methods. The research was carried out at the bases of the Nur-Sultan Multifunctional City Hospital №2 and the Nur-Sultan Multifunctional City Hospital №1. Statistical analysis of the results was carried out using the methods of variation statistics with the calculation of M ± SD. Differences between comparison groups were analyzed using the Wilcoxon-Man-Whitney test and were considered statistically significant at p≤ 0.05. From 2017-2021, 64 patients with acute destructive pancreatitis were treated according to the developed and implemented treatment algorithm: Of these: AP without organ failure and local or systemic complications -10 people. AP of moderate and severe form -54 people. Lethal outcomes-1; The average length of stay in the hospital is 20.8±1.2 days; The mean age was 43 ± 1.3 years. The control group - treatment of patients with moderate and severe acute biliary pancreatitis without the use of ulinostatin (hereinafter US) was n = 122; Lethal outcomes-8. An algorithm for the use of US was developed and implemented depending on the severity of the course of destructive pancreatitis in the complex treatment of patients with AP. Results. 10 patients were treated conservatively. 54 - surgical treatment was combined with the appointment of US according to the developed scheme. Endoscopic surgery was performed in 51 patients; 3 patients were operated on by laparotomy. The average duration of hospital stay in the main group was 3.5±0.34 days less than in the control group. Conclusion. The research results showed the high efficiency of the developed algorithm for endovideosurgical treatment of AP in combination with the use of the US. Received AC №14704 dated January 27, 2021 (www.kazpatent.kz).","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134452578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diyar Akhmet, Zhasulan Baimakhanov, E. Nurlanbayev, A. Matkerimov, A. Chormanov, B. Baimakhanov
Purpose of the study. Conduct a retrospective comparative analysis of the results of laparoscopic and traditional methods of inguinal hernia repair, patients treated at the surgical departments at “A.N. Syzganov National Scientific Center of Surgery”, Almaty, Kazakhstan. Materials and methods. In the period from January 2017 to December 2020 137 patients were operated at the “A.N. Syzganov National Scientific Center of Surgery” in a planned manner for inguinal hernia and all patients were divided into 2 main groups: operated by traditional methods and laparoscopic method. Results.The data of the analysis suggests that the laparoscopic method of hernioplasty has an advantage over the traditional methods. Conclusion. Based on a comparative analysis of the indicators of patients in both groups, it can be concluded that the duration of the operation for laparoscopic hernia repair is 92.3 minutes, significantly more than with traditional methods, which is 79.4 minutes. Despite this, the duration of analgesic therapy in the postoperative period with laparoscopic hernia repair is 2.4 days, and the duration of hospital stay after surgery is 3 days, much less than with traditional methods, in which the duration of analgesic therapy in the postoperative period is 3, 3 days, and the duration of hospital stay after surgery is 4.6 days. This analysis suggests that laparoscopic hernioplasty has an advantage over traditional methods.
{"title":"COMPARATIVE ANALYSIS OF THE RESULTS OF PLASTIC INGUINAL HERNIA LAPAROSCOPIC AND TRADITIONAL METHODS","authors":"Diyar Akhmet, Zhasulan Baimakhanov, E. Nurlanbayev, A. Matkerimov, A. Chormanov, B. Baimakhanov","doi":"10.35805/bsk2021iv027","DOIUrl":"https://doi.org/10.35805/bsk2021iv027","url":null,"abstract":"Purpose of the study. Conduct a retrospective comparative analysis of the results of laparoscopic and traditional methods of inguinal hernia repair, patients treated at the surgical departments at “A.N. Syzganov National Scientific Center of Surgery”, Almaty, Kazakhstan. Materials and methods. In the period from January 2017 to December 2020 137 patients were operated at the “A.N. Syzganov National Scientific Center of Surgery” in a planned manner for inguinal hernia and all patients were divided into 2 main groups: operated by traditional methods and laparoscopic method. Results.The data of the analysis suggests that the laparoscopic method of hernioplasty has an advantage over the traditional methods. Conclusion. Based on a comparative analysis of the indicators of patients in both groups, it can be concluded that the duration of the operation for laparoscopic hernia repair is 92.3 minutes, significantly more than with traditional methods, which is 79.4 minutes. Despite this, the duration of analgesic therapy in the postoperative period with laparoscopic hernia repair is 2.4 days, and the duration of hospital stay after surgery is 3 days, much less than with traditional methods, in which the duration of analgesic therapy in the postoperative period is 3, 3 days, and the duration of hospital stay after surgery is 4.6 days. This analysis suggests that laparoscopic hernioplasty has an advantage over traditional methods.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116368266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Abdramanov, E. Kokoev, Parida Arzibaeva, Ayday Abdramanova
Purpose of the study. Study of the prevalence of congenital heart defects among schoolchildren in the Kyrgyz Republic. Materials and methods. The material for the study were 38598 schoolchildren aged 6 to 16 surveyed in Jalal-Abad, Osh, Batken and Naryn regions. Using the instrumental technique, 2919 children out of all schoolchildren underwent an echocardiographic (EchoCG) study. The indication for echocardiography of the study was presence of a heart murmur, revealed by auscultation. Results. Based on the study, the authors identified 171 (5.8%) cases of congenital heart defects. Conclusion. The presented results indicate changes in the size of the heart cavities, valve apparatus and pressure in the pulmonary artery with an enriched pulmonary circulation. With tetralogy of Fallot and pulmonary atresia, there is an increased size of the pancreas and a smaller size of the left ventricle. More complex defects are detected at a younger age. All of the above indicates the need to optimize early diagnosis and management tactics for children with congenital heart defects.
{"title":"PREVALENCE OF CONGENITAL HEART DISEASES IN CHILDREN OF SCHOOL AGE ACCORDING TO ECHOCARDIOGRAPHY DATA","authors":"K. Abdramanov, E. Kokoev, Parida Arzibaeva, Ayday Abdramanova","doi":"10.35805/bsk2021iv048","DOIUrl":"https://doi.org/10.35805/bsk2021iv048","url":null,"abstract":"Purpose of the study. Study of the prevalence of congenital heart defects among schoolchildren in the Kyrgyz Republic. Materials and methods. The material for the study were 38598 schoolchildren aged 6 to 16 surveyed in Jalal-Abad, Osh, Batken and Naryn regions. Using the instrumental technique, 2919 children out of all schoolchildren underwent an echocardiographic (EchoCG) study. The indication for echocardiography of the study was presence of a heart murmur, revealed by auscultation. Results. Based on the study, the authors identified 171 (5.8%) cases of congenital heart defects. Conclusion. The presented results indicate changes in the size of the heart cavities, valve apparatus and pressure in the pulmonary artery with an enriched pulmonary circulation. With tetralogy of Fallot and pulmonary atresia, there is an increased size of the pancreas and a smaller size of the left ventricle. More complex defects are detected at a younger age. All of the above indicates the need to optimize early diagnosis and management tactics for children with congenital heart defects.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126196705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of the study. To study the nature and dynamics of changes in humoral and local immunity during laser photodynamic therapy in patients with diffuse forms of autoimmune thyroiditis. Materials and methods. Laboratory tests of blood plasma were performed on 160 patients with long-lasting autoimmune thyroiditis in different age groups to determine humoral and local immunity. Here, information on the level of immunoglobulins A, G, M (IgA, IgG, IgM), the amount of interleukin-1 β (IL-1 β), tumor necrosis factor α (TNF-α) was determined in blood samples by the immunoenzyme method. The dynamics of laboratory parameters in all three groups of patients were studied on days 7 and 15 of treatment. These values were determined using reactives from “VectorBest” LLC (Russia). Results. In elderly patients with long-term autoimmune thyroiditis, a downward trend in TNF indices has been observed, which is an indication of the severity of the pathological process. The higher the amount of α2-MG in autoimmune thyroiditis and diffuse toxic urination, and the slower the normalization during treatment, the higher the probability of recurrence of the process. Conclusion. The combined use of modern laser technology in the treatment of patients with autoimmune thyroiditis expands the possibilities of conservative therapy and complements the arsenal of effective methods of treatment of this disease. The simplicity of the methods, ease of application, reliability, the absence of thermal effects on the thyroid gland creates ample opportunities for the application of this method in clinical practice.
研究的目的。目的:探讨漫漫性自身免疫性甲状腺炎患者在激光光动力治疗过程中体液免疫和局部免疫变化的性质和动态。材料和方法。本文对160例不同年龄组的慢性自身免疫性甲状腺炎患者进行了血浆实验室检测，以确定体液和局部免疫。在这里，免疫球蛋白A, G, M (IgA, IgG, IgM)的水平，白细胞介素-1 β (IL-1 β)，肿瘤坏死因子α (TNF-α)的量通过免疫酶法测定血液样本。在治疗的第7天和第15天对三组患者的实验室参数动态进行了研究。这些值是使用来自“VectorBest”LLC(俄罗斯)的活性物质确定的。结果。在老年长期自身免疫性甲状腺炎患者中，观察到TNF指数呈下降趋势，这表明病理过程的严重程度。自身免疫性甲状腺炎和弥漫性毒性排尿中α2-MG含量越高，治疗过程中正常化越慢，其复发概率越高。结论。现代激光技术在自身免疫性甲状腺炎患者治疗中的联合应用扩大了保守治疗的可能性，并补充了治疗这种疾病的有效方法。方法简单，易于应用，可靠，对甲状腺没有热效应，为该方法在临床实践中的应用创造了充足的机会。
{"title":"EVALUATION OF IMMUNOLOGICAL CHANGES IN PATIENTS WITH DIFFUSE FORM OF AUTOIMMUNE THYROIDITIS DURING LASER PHOTODYNAMIC THERAPY","authors":"Rauf Aghayev, F. Sadikhov, F. Aliyev","doi":"10.35805/bsk2021iv032","DOIUrl":"https://doi.org/10.35805/bsk2021iv032","url":null,"abstract":"The purpose of the study. To study the nature and dynamics of changes in humoral and local immunity during laser photodynamic therapy in patients with diffuse forms of autoimmune thyroiditis. Materials and methods. Laboratory tests of blood plasma were performed on 160 patients with long-lasting autoimmune thyroiditis in different age groups to determine humoral and local immunity. Here, information on the level of immunoglobulins A, G, M (IgA, IgG, IgM), the amount of interleukin-1 β (IL-1 β), tumor necrosis factor α (TNF-α) was determined in blood samples by the immunoenzyme method. The dynamics of laboratory parameters in all three groups of patients were studied on days 7 and 15 of treatment. These values were determined using reactives from “VectorBest” LLC (Russia). Results. In elderly patients with long-term autoimmune thyroiditis, a downward trend in TNF indices has been observed, which is an indication of the severity of the pathological process. The higher the amount of α2-MG in autoimmune thyroiditis and diffuse toxic urination, and the slower the normalization during treatment, the higher the probability of recurrence of the process. Conclusion. The combined use of modern laser technology in the treatment of patients with autoimmune thyroiditis expands the possibilities of conservative therapy and complements the arsenal of effective methods of treatment of this disease. The simplicity of the methods, ease of application, reliability, the absence of thermal effects on the thyroid gland creates ample opportunities for the application of this method in clinical practice.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"121 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126271891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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