44
Material and metho
ds:
From August 2018 to August 2019, in
our
medical center
52
infant patients
underwented
tubuless mini-PCNL
with
antegrade
stent
tether.
All
procedures
performed by Storz
M1P
system 12F nephroscope, using
16F
metallic
sheath. Stone
fragmentation was
performed
holmium laser
and
pneumatic lithitriptor.
All
cases was
finished
with
antegrade stent placement w ith proximal tether
via
percutaneous tract, which
protected by a clear occlusive bandage. The prolen thread was sutured through
the
proximal
lumen of
stent and from inside
to
outside which contributed to
the
easy removal while
minimizing damage
to
surrounding tissue with
the
tip of
the
stent.
Results:
A total of
52
children
-
(42 male,
10
female),
with a
mean age 54,5 (17-75)
months
w
ere included
in
this
study.
The mean size
of
the stones
w
as
19.0
(15-24) mm.
Renal
stones were located
in renal
pelvis (n=34), lower pole (n=l
1
),
middle
pole/upper pole {n=7).
All
intrarenal
access was performed in
the prone
position under ultrasound and fluoroscopic
guidance. Stone
free rate was 98%.
Mean
operative
time
w
r
as 68.5 (45-92)
min.
Hospital stay
time was 2-3 days in
all
cases.
In
all
cases ureteral stent removed
by
tether via
flank
without
anesthesia,
in
40
(76%)
cases
in
third
day
and
in
12
(24%) cases
in
fifth day after surgery
7
.
There was no incidence
of
bleeding and
pain
during stent removal.
Conclusions:
Tubeless
mini
PCNL
with
stent tether is
safe
and effective technique for
preschool
children wich
avoids possibility of postoperative cystoscopy, anaestesia, hospital
stay and allows easy access to calyceal system for second look nephroscopy w
r
hen it needs.
TREATMENT
OF
PATIENTS
WITH
PROGRESSING
PRIMARY
GLALCAMA WITH NORMALIZED INTERN AL EYE PRESSURE
Mirbabaeva F.A., Yangieva N.R_, Semenov L, Клоп V., Rakhimova A.
Tashkent state dental institute
Relevance.
Despite
significant advances
in microsurgical treatment
of glaucoma,
glaucomatous optic neuropathy (GON) continues
to
progress
in
more
than
half of patients. Lt
is proved
that the
main pathogenetic factors of its development after normalization of LOP are
hemomicrocirculation disorders and
the
associated violation of transcapillary
exchange
in
the
optic nerve. This causes damage
to the axons
of the ganglion cells,
leading to
their apoptosis
and death. According
to leading
glaucomatologists,
the
pathogenetically targeted treatment is
the use
of
medications with neuroprotective and
antioxidant
effects. In clinical
medicine, in
particular, in the treatment of ischemic brain conditions,
the drug
of complex action,
Gliatilin,
is widely used. Gliatilin
-
choline
alfoscerate is
a
central
cholinomimetic
with a
primary
effect
on the
central
nervous
system.
The composition
of
the
drug
includes 40.5% of
choline
released from
the compound in
the
brain;
choline
is involved in the biosynthesis of acetylcholine (one of the
main
mediators
of nervous
excitation).
Alfoscerate is biotransformed to glycerophosphate, which is
a
precursor
of
phospholipids. Acetylcholine
has a
positive effect on
the
transmission of петле impulses,
and
glycerophosphate is involved
in the
synthesis
of
phosphatidylcholine (membrane
phospholipid),
resulting
in
improved membrane elasticity and receptor function.
Gliatilin increases cerebral blood flow, enhances metabolic processes and activates
the
45
structure
of
the
reticular formation
of
the
brain, and also restores consciousness
in
traumatic
brain damage.
It
has a preventive and corrective effect on factors of involutional psycho- organic
syndrome,
such
as
a
change
in the
phospholipid composition of the membranes of neurons
and
a
decrease
in
cholinergic activity.
The aim of
the
work was to study the feasibility and clinical effectiveness of
the
use
of
gliatilin
in
patients with unstable glaucoma with persistently normalized I OP.
Materials
and
methods.
Under observation were
45
patients
(81
eyes) with
an
unstable
course
of
POAG with persistently normalized I OP. Among them were 49 eyes
with
developed
and 32
with
advanced stages of glaucoma The age of patients ranged from 51 to 73 years, and
the
level
of
1OP
-
from 18 to 23 mm Hg. Patients were divided into two
groups,
comparable
in
age, sex, stages
of
glaucoma,
the
level of
I OP.
The
first
group included 17 patients (34 eyes). These patients underwent traditional
treatment, including parabulbar injections of 0.5 ml of
1%
solution
of em
oxipin, intravenous
drip infusions
of 50-100 mg
of
pentoxifylline, 250 mg
of
ascorbic acid
and
oral administration
of
lipoic acid 25 mg 3 times
a
day.
The second group consisted of 28 people (45 eyes), Patients
of
this group,
instead
of
intravenous infusion of pentoxifylline and ascorbic acid, received intramuscular injections of
1000
1
4.0 Gliatilin
per
day
and
intravenous infusions of 200 mg of Actovegin. The duration of
treatment
in
both
groups was
10
days.
All patients underwent visometry and perimetry with
the
determination
of
the
total
boundaries of
the field
of view (CPS). We also studied the indicators of regional hemodynamics
-
the linear velocity of blood
flow in
the suprablock artery (LSC NBA);
studied
the level of
microcirculation of
the
bulbar conjunctiva; ocular perfusion pressure
(P
perf.)
was
determined
using
the Lobstein formula.
The results of
the
study.
The
effectiveness
of
treatment was evaluated immediately
after its completion. In
both
groups,
at
the
end
of treatment,
there
was a vary ing degree of
positive dynamics in
visual
functions.
Thus,
the increase
in
GPA in
patients
of
the
1st (control)
group was
on
average 1.9%, and
in the
2nd (main) group
-
by
1
9.7%.
In addition, in this group
of
patients, a decrease
in
the size
and
number of relative paracentral
cattle
was revealed. In
45.6%
of
the eyes of patients
of
the 1
st and 53.3% of
the
eyes of
the 2nd
group,
an
increase
in
visual acuity was revealed above
the
initial level by 5.2% and 22%, respectively (p
0.05).
An increase
in
regional hemodynamics and microcirculation
in
patients of both groups
was also detected, but
their
degree also turned
out to
be different. So, the NSC BFV increased
by 7.1% (p <0.05)
in the
control group and by 36.2% (p <0.02) in patients receiving gliatilin:
Ocular Rperf.
-
increased by 6.1% and by 38.8%, respectively
(p
<0.02). Biomicroscopy
showed a significant increase
in
DA by 1.9% and 13.1%, respectively; PFC
in 1 mm2
field of
view at 13.6%
and
50%, respectively (p <0.03).
INDEXES OF TRACE HEMOPOIETIC
ELEMENTS
IN
ADOLESCENTS
HEALTHY AND WITH
HYPOMICROELEMENTHOSES
RESIDING IN AN
INDUSTRIAL
CITY CONDITIONS
