The study includes 557 patients with ulcer of the stomach and duodenal intestine complicated by bleeding. The control group was 290 patients, of which 48 patients with active bleeding were performed by standard endoscopic hemostasis techniques, and in 242 cases, when verifying stopping bleeding, endoscopy was limited to the diagnostic step with subsequent conservative patient management. The main group includes 267 patients in addition to endoscopic hemostasis with active bleeding (46 patients), the manipulation was supplemented with the implementation of the proposed method of endoscopic treatment of gastroduodenal bleeding of ulcerative genesis. When revealed bleeding (221 patients), endoscopic intervention was also accompanied by the implementation of the proposed method.
The application of the composite polymer material over the ulcerative defect contributed to a decrease in the frequency of the nearest recurrences of hemorrhagic syndrome from 9.0% to 1.9%, reduce the need to perform operational treatment from 6.6% to 1.1% and levity indicator from 1.7% up to 0.7%, which generally affected the increase in the share of patients discharged without complications from 90.7% to 97.8% and reducing the timing of the hospital phase of treatment.
Purpose of the study. To assess the effectiveness of the use of hemostatic agent "GEMOGUBKA" for the prevention of bleeding from the bed of the gallbladder during traditional cholecystectomy. Methods. The study included 88 patients operated for acute calculous cholecystitis. Depending on the method of bleeding hemostasis, all patients were divided into 2 groups: in the study group (n=43), after cholecystectomy, 250-300 mg of "GEMOGUBKA" in the form of a fine powder was applied to the gallbladder bed for hemostasis; in the control group (n=45), after cholecystectomy, hemostasis was carried out by electrocoagulation of the gallbladder bed with a monopolar electrode. All patients in the postoperative period underwent control-dynamic ultrasound examination, study of the volume and nature of the discharge from the drains, as well as a biochemical blood tests. Results. In the study group, the average duration of hemostasis with bleeding from the bladder bed was 2,3±1,3 minutes, which is almost 2 times less than in the control group - 4,2±1,5 minutes. The duration of bed-days after surgery was 4,5±0,78 days and 6,3±2,06 days, respectively. The duration of the presence of the drainage tubes in the abdominal cavity in the study group was 1,49±0,88 days, while in the control group it was 4,24±1,38 days. The dynamics of the manifestation of cytolytic syndrome showed a low degree of intraoperative aggression during hemostasis in the study group, which significantly differed from the high rates of cytolysis in the control group. In the study group of patients, it was possible to significantly reduce the proportion of serous-hemorrhagic and hemorrhagic discharge from the drainage tube in comparison with patients in the control group. Conclusion. The use of the biocomposition in the form of the hemostatic drug "GEMOGUBKA" allowed both to reduce the duration of bleeding from the bed of the gallbladder, and the incidence of local inflammatory complications of the surgical site during traditional cholecystectomy.
The possibilities of endoscopic surgical correction of colon pathologies in children have been studied. The features of endoscopic surgery for congenital pathologies of the colon in children are assessed. The review analyzes the effectiveness of endosurgical correction of congenital colon pathologies in children. The characteristic complications after endosurgical correction of colon pathologies are analyzed in detail. The use of the endoscopic technique in patients with colon pathologies allows minimizing postoperative complications
Activation of the system of hemostasis in preeclampsia creates a premorbid background for thrombohemorrhagic complications. Hemostasis disorders increase the risk of severe bleeding during labor and cesarean section. During surgical interventions against the background of thrombocytopenia and thrombocytopathy (even with careful stopping of bleeding) bleeding is possible, including delayed bleeding. The same is observed in coagulation factor deficiency.
The aim of the study is to development of an algorithm for managing pregnancy and childbirth by studying the functional state of the mother-placenta-fetus system in pregnant women who have undergone COVID-19 in different trimesters of pregnancy.
The object of the study was 105 pregnant women who, were treated at the Samarkand Regional Perinatal Center and a specialized maternity center for pregnant women with COVID-19
Тhe scientific novelty of the research consists of the followings: for the first time in pregnant women infected with COVID-19, a relationship was established between the course of pregnancy, childbirth, the postpartum period and the development of complications depending on the trimester and severity of the disease; a direct correlation has been established between the state of the vessels of the mother-placenta-fetus system (resistance and pulsation indices, Endothelin-1 indicators), disorders in the hemostasis system (D-dimer, platelet aggregation) and the clinical course of the disease in pregnant women who underwent COVID-19; it has been established for the first time that the developed scale for assessing risk factors for non-developing pregnancy in women infected with COVID-19 (age, BMI, obstetric history, gestation period, hemostasis system status, endothelial function and severity of the disease) can serve as a prognostic marker of the degree of risk of pregnancy complications; it was proved for the first time that the choice of effective therapy for restoring hemodynamics in the mother-placenta-fetus system, in women who underwent COVID-19 at different stages of pregnancy, leads to a decrease in the number of thrombophilic complications.
Implementation of the research results. The results of the scientific research were introduced into the practical activities of the Samarkand Regional Perinatal Center by Order No. 128/1 of 01.09.2022 and the Samarkand City Maternity Complex No. 1 by order No. 58/1 of 03.10.2022. In pregnant women who underwent COVID-19 at different periods of pregnancy, changes in the mother-placenta-fetus system were determined using simple and effective research methods, such as ultrasound and Dopplerography, and this saved 53,000 soums; obstetricians and gynecologists, as well as neonatologists and therapists, are needed to diagnose signs of complications in the echocartin, that is, it has been proven that there is no need for other highly qualified specialists for this, due to the lack of need to train new personnel, state budget funds have been saved. With early detection of disorders in the hemostasis system in pregnant women with COVID-19: the period of stay of patients in the hospital was reduced from 10.5 days to 7.5 days and the number of hospital bed days was reduced; due to the reduction of the period of stay in the hospital for several days, the number of necessary drugs was reduced (on average, drugs are used for 1 day in the amount of 130,000 soums). Examination of pregnant women infected with viral diseases using simple and effective research methods such as ultrasound and Dopplerography served to save 85,000 soums: in the early stages up to 16 (10-11 weeks. - fetometry), 19-21, 32-34, 38-40 weeks of pregnancy; due to the absence of the need to use other research methods, it was possible to reduce costs by 23.5%; early detection of changes in the hemostasis system and endothelial dysfunction using fast, budgetary and effective research methods, contributed to the prevention of possible pregnancy complications, as well as the absence of the need to use long-term and expensive research methods, and this saved 106 000 soums: the coagulogram was checked in 105 (100%) patients, time was saved and efficiency was increased; endothelin-1 was also determined in 105 (100%) patients, efficiency was increased by 78.6%.
Improving the functionality of blood circulation in the uteroplacental and fetal-placental systems, a comprehensive analysis of possible complications during pregnancy and childbirth in women who have had viral infections, improving diagnostic, preventive and prognostic measures for managing pregnancy and childbirth contributed to the birth of live, full-term and healthy newborns in women who experienced COVID-19 during pregnancy, as well as a decrease in maternal mortality and perinatal mortality, 43% of women underwent rehabilitation in the postpartum period, 23.8% of women who underwent severe COVID-19 improved their quality of life.
To introduce scientific novelty on the topic “The impact of COVID-19 on the state of hemodynamics in the mother-placenta-fetus system in pregnant women”, a letter was sent to the Ministry of Health from Samarkand State Medical University on November 9, 2022 under No. 4295 (Conclusion of the Ministry of Health No. 8 n-z / 679 of December 15, 2022).
The structure and volume of the dissertation. The content of the dissertation consists of an introduction, five chapters, conclusion, list of used references. The volume of the dissertation consists of 113 pages.
In preterm infants, hypocoagulation is observed, which is most pronounced in deeply premature infants. The main mechanisms and stages of coagulation reflect ontogenetic differences in the formation of the coagulation system, when the hypocoagulation orientation of the indicators decreases significantly after the 32nd week of gestation. In newborns with a gestational age of up to 32 weeks, the intensity of plasma hemostasis is revealed, which may be due to the intensity of hemostasis and the variability of its components. In the dynamics of the early neonatal period, preterm infants did not show any coagulation changes in the APTTV and TV tests, and the test scores of external coagulation mechanisms were most reduced in the first days of life
This article presents the results of surgical treatment of benign prostatic hyperplasia (BPH) by the method of transvesical adenomectomy. Tamponing of the removed adenoma bed, suturing of the bed, lowering the bladder neck and the use of a 10% infusion of lagochilus as a local hemostatic were used as methods of hemostasis in adenomectomy. The results of surgical treatment are presented depending on the presence or absence of chronic kidney disease (CKD) in patients. The influence of the hemostasis technique on the improvement of renal function in the postoperative period is shown.
Bleeding from esophageal varices is considered as a devastating complication of theportal hypertension, with a high rate of mortality. However, prophylaxis and management of bleeding fromesophageal varices currently is still a matter of debate for children with portal hypertension. According to endoscopic criteria and recent reports, endoscopic reduction of esophageal varices (EST, EVL) has been considered as a beneficial and important method in children population.
Significant changes of the vascular-thrombocytic component of the hemostasis system were revealed in patients with different stages of diabetic retinopathy. Treatment with activated autoplasma contributed to approaching all investigated parameters of vascular-thrombocytic and procoagulant components to their initial values.