___________________________________________________________________________________Цель. Улучшить репаративную регенерацию в тканях при применении оксиметилурацила у хирурги ческих больных. Материалы и методы. Влияние 5 оксиметилурацил 2,4 диоксо 5 гидрокси 6 метил 1,2,3,4 тетрагид ропиримидина (5 ОМУ) на процессы стимуляции регенерации в тканях оценивалось в четырех группах, включавших разные органы и системы организма. Анализ результатов применения 5 ОМУ при наличии вялотекущих ран в общей хирургии проведен у 145 пациентов, при эрозивно язвенном поражении верхних отделов желудочно кишечного тракта (ЖКТ) -у 126, при реконструктивно восстановительных операциях на ЖКТ -у 105 и при проведении реваскуляризирующих вмешательствах на сердце -у 63. Для создания экспериментальных моделей использовались половозрелые кролики массой 2,9 ± 1,7 кг, возраст -от 11 до 12 месяцев. Проведены две серии опытов с резаными и ожоговыми ранами. Результаты. На основании проведенных экспериментальных исследований, после изучения гистоло гических и гистохимических препаратов выявлено положительное влияние оксиметилурацила на за живление кожных ран. Выводы. На основании проведенных работ препарат рекомендован к применению и в других областях хирургии для лечения эрозивно язвенных поражений верхнего отдела желудочно кишечного тракта, при наложении анастомозов кишечника и выполнении реваскуляризирующих операций на сердце. Разработа ны различные лекарственные формы препарата для достижения максимальной концентрации его в тканях, проведены клинические испытания и доказана эффективность его применения в клинической практике. Ключевые слова. Оксиметилурацил, стимуляция регенерации, эксперимент.Aim. To improve the reparative tissue regeneration, applying oxymethyluracil in surgical patients. Materials and methods. The impact of 5 oxymethyluracil 2,4 dioxo 5 hydroxy 6 methyl 1,2,3,4 tetrahydropirimidine (5 OMU) on the processes of regeneration stimulation in the tissues was studied in 4 groups, including different organs and systems of the body. The analysis of the results of using 5 OMU for torpid wounds in general surgery included 145 patients, erosive ulcerous lesion of the upper parts of gastro intestinal tract -126, reparative surgeries on GIT -105 and revasculizing interventions on the heart -63.
Aim. To improve the immediate and long-term results of diabetic foot syndrome treatment, using modern surgical techniques. Materials and methods. The results of treatment of 264 patients were analyzed. For these patients with purulo-necrotic affection of extremities against the background of diabetes mellitus, complex treatment, including the techniques of extremity revascularization as well as modern hydrocolloid bandage materials, depending on the stage of wound process, was used; different variants of foot unloading at the clinical and ambulatory stages were offered. The method of treatment of purulo-necrotic wounds against the background of diabetes mellitus, based on differentiated use of ozonotherapy combined with application of biomaterials for closing ulcerous defects, was developed and introduced by the authors. Results. The systemic approach and criteria for choosing surgical strategy of diabetic foot syndrome treatment were worked out and presented. The immediate and long-term results of using the introduced scheme of the management of patients were studied. Conclusions. The developed complex approach is aimed at preservation of the foot and supporting function of the lower extremity; its clinical use permits to decrease the percent of amputations and lethality, improving patients’ quality of life indices.
The article presents the results of treatment of 201 patients with neuroischemic form of diabetic foot syndrome. The research included 158 women and 43 men of the middle age of 62,5±11,2 years. The complex approach was applied in treatment includ ing medicamentous treatment, revasculization of extremity, an application of modern combined collagenous coating and foot relieving using silicone insoles and orthopedic footwear. The endovascular and open reconstructive operations were performed in order to obtain the revasculization of extremity. Given complex approach allowed reducing the terms of hospital stay, the rate of ulcerous defects recurrences and relapses of ischemia of lower extremities during one year after endovascular interventions.
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