Biomedical subjects
Publications and source records attributed to Iu B Shapot.
The authors share their experiences with treatment of 12 patients using the antibiotic Tienam. No complications resulting from the administration of this medicine were noted. High therapeutic efficiency of Tienam has been shown. Recovery was noted in 11 out of 12 patients.
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Based on the experience with treatment of 26 patients the authors recommend to use mainly conservative treatment with the intrapleural administration of fibrinolytic drugs. The method was used in 20 patients. All of them recovered.
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Complications were noted in 83% of patients with an associated trauma of the chest. Bilateral pneumonia was the most frequent complication (57.7%), then were traumatic pulmonitis (15.9%) and total pulmonary edema (18%). The adequate anesthesia, liquidation of a disturbance of the chest carcass, timely elimination of hemo- and pneumothorax are thought to be the most effective measures of struggle against pulmonary complications in patients in the early period of the trauma disease. The complex treatment has given 1.5 times less amount of pulmonary complications.
Prolonged regional anesthesia used for relieving pain was given to 65 patients with closed traumas of the chest complicated by fractures of the ribs. The method was shown to be effective, simple and safe. It may be used both at the hospital and at prehospital stage. The prolonged regional anesthesia allowed reducing the amount of pulmonary complications from 4.5% to 1.7%.
The authors have analyzed 110 patients and describe most frequent errors in diagnosis and treatment. They are: not complete examination of the victims, non-radical primary surgical treatment of the wounds, irrational and late drainage of the pleural cavity in hemothorax and pneumothorax.
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Analysis of the work of surgical-reanimation teams of the Accident Station and the City Shock Center has shown that their joint activity can provide modern level of giving help to patients with traumatic shock. In organization of work of the City Shock Center of great importance is the distribution of duties among the team members.
The authors analyze their experience with the treatment of 64 patients with injured urinary bladders in associated traumas. In diagnosis of this pathology great significance is attached to contrast vesicography. Suturing the urinary bladder should be finished by epicystostomy.
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Extramedullary osteosynthesis of ribs was performed in 18 patients with apparatus SPG-20 for multiple rib fractures. The early surgical treatment of patients with thoracic traumas resutled in a substantial improvement of the external respiration function, the volume of intrapulmonary shunt, alveolar-arterial oxygen gradient and respiratory index being considerably decreased. The use of a mechanical suture of the ribs as a component in the complex treatment of patients with a thoracic trauma is an efficient method in the struggle against posttraumatic respiratory insufficiency and shock.
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