The aim of the research work is to improve the results of treatment of patients with combined injuries of the pelvis and femur, by developing tactical and technical aspects based on the severity of the injury and the severity of the condition.
The object of the study was 130 patients with injuries of the pelvic and hip bones with concomitant trauma, treated at the Republican Scientific Center for Emergency Medical Aid and its Samarkand branch for the period 2016-2021 years.
The scientific novelty of the research work is the following: the structure and frequency of combined injuries of the pelvis and femur in the general structure of injuries, in the structure of injuries to the pelvis and femur separately were evaluated. the risk factors for the development of unsatisfactory results of treatment of concomitant injuries of the pelvis and hip, based on traditional clinical and diagnostic standards, have been determined; a direct relationship has been proven in the dynamics of the condition of the victims and the prognosis, taking into account the type and nature of segmental injuries; the device for external fixation for stable functional minimally invasive osteosynthesis has been improved and the possibility of expanding the indications for surgical treatment for combined injuries of the pelvis and hip in the early period of traumatic disease has been proved; the technical advantages of a complete set of an improved rod device for external fixation have been proved, the pelvic and femoral versions of which make it possible to use them for effective stabilization of the pelvis and hip separately during anti-shock measures, and for the final reposition of bone fragments; the direct dependence of treatment results on the proposed tactics of providing trauma care at an early hospital stage, depending on the type, nature, severity of pelvic and hip injuries, and the severity of the condition has been proved.
The introduction of research results. Based on the results of scientific research to improve the surgical aspects of providing assistance to victims with concomitant injuries of the pelvis and femur: based on the results of the development of a device for the treatment of fractures, a patent for an invention was obtained from the Intellectual Property Agency of the Russian Federation "Apparatus for the treatment of combined fractures of the pelvic and hip bones" (patent No. 2749897 dated 06/18/2020). The results obtained made it possible to improve the tactics of surgical treatment of patients, to shorten the period of hospitalization and the period of postoperative rehabilitation, to ensure the possibility of patients with minimal economic costs; on the basis of the results of scientific research on the diagnosis and treatment of concomitant injuries of the pelvic and femur bones, methodological recommendations were approved "Method for the treatment of victims with concomitant injuries of the pelvis and hip, depending on the severity" (Conclusion of the Ministry of Health of the Republic of Uzbekistan No. 8 n-z / 288 dated August 31, 2021 of the year). The results obtained made it possible to improve the quality of wound diagnosis and rehabilitation of patients with injuries of the pelvic and hip bones in concomitant injury; approved methodological recommendations "Tactics of rendering assistance to victims with combined injuries of the pelvis and hip, taking into account the severity of the condition" (Conclusion of the Ministry of Health of the Republic of Uzbekistan No. 8 n-z / 288 of August 31, 2020). The results obtained made it possible to improve the tactical and technical aspects in the treatment of injuries to the pelvic and hip bones, based on the severity of the injury and the severity of the patient's condition.
Scientific results have been introduced into the practical activities of healthcare, in particular, the Samarkand branch of the Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics, the Jizzakh Branch of the Republican Scientific Center for Emergency Medical Aid, the Samarkand branch of the Republican Scientific Center for Emergency Medical Aid (certificate of the Ministry of Health No. 08-09 / 18979 dated December 02, 2021). The proposed tactics for the treatment of combined injuries of the pelvis and femur made it possible to reduce the incidence of postoperative complications of excellent and good long-term functional results from 66.1% to 92.6%.
The structure and scope of the dissertation. The dissertation consists of an introduction, five chapters, conclusions, practical recommendations, a list of referencesand applications. The volume of the text material of the work is 111 pages.
Наличие воспалительного процесса и/или неспецифической инфекции в нижних женских половых путях способствуют возникновению субклинического воспалительного заболевания органов малого таза (ВЗОМТ); такая субклиническая патология характеризуется аналогичными для острого ВЗОМТ рисками и осложнениями, в том числе и после хирургических вмешательств - вследствие воспалительного каскада, запускаемого эндотоксинами грамотрицательных микроорганизмов и последующей ответной воспалительной реакции.
In the structure of inflammatory diseases of the internal genital organs in women, a special place is occupied by purulent-inflammatory lesions, which are the main cause of disability in women of reproductive age due to the need for surgical treatment. In 4–5% of women, purulent inflammatory diseases of the fallopian tubes and ovaries are diagnosed. The purpose of this study was to introduce and evaluate the effectiveness of new methods of treatment and prevention of purulent-inflammatory diseases of the small pelvis in women. In order to develop preventive measures for the development of purulent-inflammatory diseases of the small pelvis, we examined 240 women of reproductive age. Our evaluation of the clinic and the results of the research methods used, as well as the outcomes of the process, made it possible to distinguish two groups with purulent-inflammatory diseases of the pelvic organs - volumetric (50; 20.8%) and non-volumetric (190; 79.2%). The diagnostic research methods used in our work contributed not only to the verification of the pathological process and the assessment of the degree of anatomical changes in the focus of inflammation, but also to the implementation of dynamic monitoring of the effectiveness of therapy with an emphasis on the implementation of the proposed optimized complex for managing patients with purulent inflammatory diseases of the pelvic organs.
In article are stated modern beliefs about possible этиологии and патогенезе placental to insufficiency beside womans' with varicose vein of the small basin. They are presented about homo sustain, fibre nectine and their possible dug in development of this pathology
Генитальный туберкулез (ГТ) является актуальной медицинской и социальной проблемой, так как чаще всего поражает женщин активного репродуктивного возраста (20–45 лет) и является причиной женского бесплодия в 10-27,8% случаев. Бесплодие является характерным и часто единственным для туберкулеза гениталий симптомом, встречается у 60–95 % пациенток. Локализациямикобактерии туберкулеза (МБТ) в 90-100% представлена в маточных трубах. Одновременно у 10-60% пациенток выявляется туберкулезное поражение эндометрия. Яичники поражаются в 6-30% случаев; туберкулез вульвы, влагалища и шейки матки встречается реже – в 1-15%.Туберкулез женских половых органов относится к наиболее трудно диагностируемым локализациям внелегочного туберкулеза и выявляется, зачастую, на поздних стадиях, когда, несмотря на проводимую терапию, восстановления менструальной и репродуктивной функций женского организма не происходит. Длительное течение воспалительных заболеваний органов малого таза и бесплодие, отсутствие эффекта от лечения воспалительных заболеваний органов малого таза, высокая частота оперативных вмешательств на придатках матки, наличие кальцинатов в миометрии и/или яичниках по УЗИ позволяют заподозрить туберкулез гениталий. Раннее выявление наряду со своевременной и адекватной специфической терапией позволяют до 34 % случаев восстановить фертильность.
Urinary incontinence in middle-aged women is a complication of severe vaginal delivery, large fetuses or multiple pregnancies, urinary incontinence, intermittent injuries and operations on the pelvic organs, obesity, diabetes, smoking. Urinary incontinence is divided into three types depending on its cause: these are stress urinary incontinence, urgent urinary incontinence, and the inability to manage full urine. Of these, a lot of women suffer from this type of stress urinary incontinence and it begins mainly after forty-five years, it happens when women sneeze or cough, laugh a lot, so women complain of involuntary urination. In turn, it is one of the first signs of the disease and also plays an important role in diagnosis. Urinary incontinence causes discomfort and stress in women, their tightness when smoking and joining in a team
The study examined the effectiveness of complex methods of ultrasound diagnostics using elastography in assessing the prevalence of cervical cancer (CC). This article presents the results of a complex ultrasound examination using elastography of 42 women aged 32-73 years. (average age is 52.1 years). Examination of the pelvic organs included a transabdominal examination (B-mode) followed by a transvaginal approach using the compression elastography technique.