低温电焊接活体软组织在眼科手术中的应用

E. Maietnyi
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摘要

目标。通过对不同方案对肺实质结核分枝杆菌和肺实质密度指标的微生物学评估,确定低温活体软组织电焊在肺实质缝合、肺门制备和淋巴结消融中的最佳应用方案,并评估其术后远期疗效。材料和方法。这项工作是基于275例患者的术后调查结果,目的是确定低温电焊软组织对肺实质和纵隔淋巴结的影响。结果。已有研究表明,在植牙外科手术中应用低温活体软组织最小自动焊接机制,可保证98.3%的患者有效消除微生物群。所显示的肺气肿突和纤维性改变是并行发生的,并在本质上影响肺-胸膜并发症的发展。研究组患者肺实质常规密度为57.5%,对照组为49.7%。两组术后远端均未见肺实质超密度增高。纵隔淋巴结密度比较,各纵隔淋巴结密度指标间差异无统计学意义。同时,在最小功率下应用低温电焊对软组织进行焊接,也有明显的基本特征:肺实质纤维转化率低于对照组,分别为13.3%和15.5%。结论。低温活体软组织电焊在淋巴结消融术中的应用表明,在保存淋巴循环和术后肺实质低刚性的情况下,存在有效的杀菌方案。在低温电焊接活体软组织的情况下,淋巴结消融手术后未出现淋巴停滞、淋巴流出障碍和肺胸膜并发症的迹象,以及在进行纵隔淋巴结清扫和切除时发生医源性损伤的风险。
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Densitometric substantiation of the application regimes in a low-temperature electric welding of soft living tissues in phthisiosurgery
Objective. To determine the optimal regimes of application of a low-temperature electric welding of soft living tissues in formation of suture in pulmonary parenchyma, the pulmonary hilum preparation, and its lymph nodes ablation, basing on microbiological estimation of action of various regimes on the tuberculosis mycobacteria and densitometric indices of pulmonary parenchyma and to estimate its efficacy in far remote postoperative period. Materials and methods. The work is based on the results of postoperative investigations in 275 patients with the aim to determine the impact of a low-temperature electric welding of soft living tissues on pulmonary parenchyma and mediastinal lymph nodes. Results. There was established, that application of minimal automatic regime of a low-temperature electric welding of soft living tissues in phthisiosurgery guarantees effective elimination of microflora in 98.3% of patients. The revealed emphysematous processes and fibrous changes are occurring in parallel and essentially impacts the development of pulmonary-pleural complications. Conventional density of pulmonary parenchyma was noted in 57.5% of patients in the investigation group and in 49.7% patients of the control group. In both groups, the enhanced superdensity of pulmonary parenchyma in far remote postoperative period was not observed. Density of mediastinal lymph nodes was compared, and statistically significant difference between densitometric indices of mediastinal lymph nodes was absent. While application of a low-temperature electric welding of soft living tissues in minimal power regime of the complex there was noted essential characteristic as well: lesser rate of fibrous transformation of pulmonary parenchyma, than in the control group –  in 13.3 and 15.5%, accordingly. Conclusion. Application of a low-temperature electric welding of soft living tissues in phthisiosurgical interventions for the lymph nodes ablation have shown the presence of effective bactericidal regimes with preservation of lymphatic circulation, and low rigidity of pulmonary parenchyma in postoperative period. While a low-temperature electric welding of soft living tissues applied, the signs of lymphostasis, the lymphatic outflow disorders and pulmonary-pleural complications in postoperative period after phthisiosurgical interventions with the lymph node ablation procedure do not occur, as well as the risk of iatrogenic damages while performing dissection and excision of mediastinal lymph nodes.
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