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Biomedical subjects

P G Kondratenko

Publications and source records attributed to P G Kondratenko.

At least 19 recordsLinked to original sources
PubMed1994

[Surgical treatment of ulcer complicated with severe hemorrhage].

The results of treatment of 380 patients with the globular volume deficiency of 40% and more, operated in urgency for ulcer gastroduodenal bleeding. In 124 (32.6%) of them ulcer was localized in the stomach, in 224 (64.2%)--in pyloroduodenal region, in 12 (3.2%)--the combined ulcers were revealed. Cause of the death was an acute cardiovascular insufficiency in 11.1% of patients, thromboembolia of the pulmonary artery--in 1.3%, bleeding ulcer or erosion--in 1.6%. Suture insufficiency of the duodenal stump and anastomoses occurred in 5.8%, pneumonia--in 12.6%, purulent complications--in 6.3%. The conduction of proposed surgical tactics permitted to lower the mortality after operations for persistent bleeding down to 12.5%, the prevalence of recurrent bleeding occurrence--to 12.5%. The prevalence of operations accomplishment in the patients with high risk of bleeding recurrence have increased up to 78.7%, radical intervention--to 70.7%. The authors make a conclusion about perspectivity of the proposed elaborated an active-rational therapeutical tactics in the patients with severe gastroduodenal bleeding.

Adolescent↗
PubMed1992

[Several aspects of improvement in the training of surgeons at medical institutes].

This paper summarizes the experience gained in the training of surgery specialists at a medical institute and determines the main shortcomings of undergraduate and postgraduate specialization. A sociological survey carried out in the groups of subinterns indicated low effectiveness of preinstitute and intrainstitute professional orientation. Great emphasis is being placed on increasing the quality of training on fundamental sciences and preclinical disciplines. A positive appreciation is being given to the long application of the unified methodological system of specialists training, the use of the syndrome method of training at the graduate year, which is based on maximum activation of clinical thinking, motivated approach to the development of practical knowledge and skills. The important role of continuity in the training of surgeons in the subinternship and internship is stressed.

Curriculum↗
PubMed1991

[Surgery in bleeding stenosing pyloroduodenal ulcer].

The results of surgical treatment of 147 patients with a bleeding stenosing pyloroduodenal ulcer are presented. The operation of choice in this pathology is a selective proximal vagotomy in combination with the original methods of ulcer excision and drainage operations, and as well a selective proximal vagotomy with antrectomy. Gastric resection is indicated in patients with decompensated stenosis of gastric outlet and pronounced disorders in motor-evacuatory function of the stomach. In patients with a severe, or extremely severe state, the ulcer excision in combination with pyloroduodenoplasty dilating the lumen is expedient.

Adolescent↗
PubMed1991

[Surgical treatment of patients with a bleeding giant ulcer of the stomach and duodenum].

The results of surgical treatment of 112 patients with a bleeding giant gastric, or duodenal ulcer, comprising 18.6% of the number of patients with acute ulcerous gastrointestinal bleeding operated on in the emergency order are presented. The use of active surgical tactics permitted to increase the specific weight of radical operations to 62.8%, reduce the incidence of early postoperative complications 1.8-fold, lethality--3.4-fold when compared with the results of the use of active-expectant tactics. An operation of choice in bleeding giant gastric ulcer is Billroth-I resection of the organ, or its suprapyloric resection; in ulcer location at the pyloroduodenal region--selective proximal vagotomy with ulcer excision, or selective vagotomy with antrectomy. To arrest bleeding in performance of minimal, or organ-preserving operation with vagotomy, it is necessary to perform ulcer excision, because after closing the bleeding ulcer, or suturing the bleeding vessel in an ulcer, 25.8% of the patients developed recurrency of the bleeding at the nearest postoperative period.

Adult↗
PubMed1991

[Blood coagulation in patients with ulcerous gastrointestinal hemorrhage].

In 108 patients with ulcerous gastrointestinal hemorrhage, the indices which characterize the coagulative and fibrinolytic systems of the blood were studied. At the moment of admission, in patients with severe blood loss, the moderate manifestations of the disseminated intravascular coagulation, which is the most characteristic in globular volume deficiency of more than 50%, were noted. After the operation, the revealed changes in the system of hemostasis increased. Beginning from the day 5, a tendency for normalization of the indices was noted, however by the moment of discharge of the patients they do not achieve the normal ones.

Adolescent↗
PubMed1990

[Surgical treatment of patients with bleeding stomach ulcers].

The results of treatment of 480 patients with bleeding gastric ulcers are presented. The more wide use of the Billroth-I gastric resection (135 patients) versus Billroth-II gastric resection (54 patients) permitted to reduce the incidence of early postoperative complications from 42.6 to 15.6%, and lethality--from 24.1 to 3.7%. The use of therapeutical tactics based on the endoscopic characteristic of a source of bleeding, evaluation of the dynamics of pathological process, severity degree of blood loss with regard for location and size of the ulcers, and with regard as well for the differential approach to the choice of a method of operative intervention permitted to reduce the total lethality from 22.8 to 7.2%, lethality after the emergency operations--from 34.4 to 13.5%, total postoperative lethality--from 23.8 to 9.5%, to increase the specific weight of radical operations from 43.8 to 69.7%, reduce lethality after conservative treatment of the patients from 21.5 to 3.7% when compared with that in active-expectant tactics.

Adolescent↗
PubMed1990

[Lipid peroxidation and lysosomal enzyme activity in patients with acute gastrointestinal hemorrhage of peptic ulcer etiology].

In examination of 51 patient with acute gastrointestinal bleeding of ulcer etiology, the activity of lysosomal enzymes, peroxide oxidation of lipids were increased, the activity of antioxidant system was decreased. This can lead to inhibition of proliferative processes, stipulating the severity of blood loss, course of the postoperative period, the incidence of postoperative complications, and lethality.

Acid Phosphatase↗
PubMed1990

[Intensive therapy of patients surgically treated in acute gastrointestinal hemorrhage of peptic ulcer etiology].

The emergency operations were performed in 6,506 patients for acute hemorrhage in gastric and duodenal ulcer. A method for the complex corrigative intensive therapy is presented. The use of combined parenteral and enteral nutrition facilitates a care of the patients, favours the prophylaxis of complications. Because of incomplete rehabilitation by the moment of patient's discharge from the hospital, it is necessary to continue the corrigative therapy directed at liquidation of the globular volume deficiency, correction of disproteinemia, normalization of the indices of central hemodynamics and metabolic processes in the organs and tissues.

Acute Disease↗
PubMed1989

[Organ-sparing operations in bleeding ulcers of the pylorus and duodenum].

The organ-preserving operations were performed in 387, gastric resection--in 142, closure or excision of an ulcer without vagotomy--in 132 patients with bleeding pyloroduodenal ulcers. The lethality after gastric resection was 11.3%: after the emergency operations--16.3%; after early elective interventions--9.1%; after the organ-preserving operations--2.6, 5.3, 0.85%, respectively.

Duodenal Ulcer↗
PubMed1989

[Ways of improving the results in treating patients with acute gastrointestinal hemorrhage of peptic ulcer etiology].

The results of treatment of 1837 patients with gastric and duodenal ulcers, complicated by bleeding are presented. Emergency surgical interventions were performed in 468 patients, 92 (19.7%) died, early elective operations--in 416 patients, 13 (3.1%) died, conservative treatment was performed in 953 patients, 55 (5.8%) died. In 1274 patients, the actively expectant tactics was used, in 563--surgical tactics based on endoscopic characteristics of the source of bleeding and degree of the severity of blood loss. The use of this tactics permitted to reduce lethality after emergency operations from 27.7 to 9.6%, in patients treated conservatively--from 7.5 to 0.8%, to increase operative activity from 44.6 to 56.1%.

Acute Disease↗