Виникненню гнійно-запальних ускладнень (ГЗУ) у потерпілих з черепно-мозковою травмою (ЧМТ) сприяє формування синдрому системної запальної відповіді (ССЗВ) і поліорганної недостатності (СПОН), ознаки яких виявляють вже в перші години після травми. ГЗУ, в свою чергу, спричиняють виникнення СПОН. Вплив ранніх ССЗВ і СПОН на частоту виникнення ГЗУ при ЧМТ недостатньо вивчений. Обстежені 277 потерпілих з ЧМТ. У 60,5% з них виникли ГЗУ з ураженням дихальної системи, у 13,1% — ЦНС, у 9,9% — сепсис, у 16,5% — поєднані ускладнення. На частоту ГЗУ достовірно впливають тяжкість ЧМТ, наявність супутніх захворювань, ССЗВ і СПОН, вираженість порушення функцій ЦНС, меншою мірою — концентрація алкоголю в крові. За наявності двох ознак раннього СПОН і більше ризик виникнення ГЗУ збільшується вдвічі, двох ознак раннього ССЗВ і більше — у 2,4 разу, що обґрунтовує доцільність застосування ранньої деескалаційної терапії, це дозволяє зменшити летальність хворих з ЧМТ внаслідок ГЗУ з 22 до 12,3%, частоту виникнення пневмонії — з 60,5 до 47%.
The issues on optimization of the restoration treatment of patients, suffering the brain meningioma, were discussed, basing on analysis of 498 observations. Tactics of the patients management in noncomplicated, complicated and severe course of postoperative period is adduced. The indices of survival and lethality, peculiarities of the infusion therapy were analyzed. The role of plasm-restituting preparations was demonstrated in complicated course of postoperative period. Rational complex approach to the restoration measures and intensive therapy conduction promotes the treatment efficacy raising, the patients fair quality of life securing in the brain meningioma in postoperative period.
In the review the state and problems of infusive therapy for today are described; comparison of different preparations for infusions is given. The application of sorbilactum — complex medicine on the sorbitolum basis — is considered in details; effects, possibilities and advantages of preparation, and also results of clinical researches are described.
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This article is devoted to the executed analysis of inflammatory infectious complication frequency, based on the 136 neurosurgical patients. Prognostic factors of complication, explaining difficulties of after-operation period, were revealed. Also the authors consider the questions of prophylaxis and treatment.
This article is devoted to the executed analysis of inflammatory infectious complication frequency, based on the 136 neurosurgical patients. Prognostic factors of complication, explaining difficulties of after-operation period, were revealed. Also the authors consider the questions of prophylaxis and treatment.
A hundred and sixteen postoperative patients after removal of various brain tumors in whom brain edema developed were treated with 1-3 courses of blood ultrafiltration (BUF). 0.5-9.0 liters of ultrafiltrate was removed. BUF does not lead to blood concentration due to the movement of the fluid from intracellular to intravascular space. BUF allows to decrease the amount of toxic medium-sized peptides and osmolarity discriminant. Seldom the minor complications were observed because of usage of the plate shaped dialyzers. When the capillary dialyzers were used, no complications were noted. BUF may be recommended in patients with brain tumors in early postoperative period when traditional medical management does not seem to be effective enough. The technique helps to reduce the duration of brain edema in treated patients by 8-10 days vs. controls treated traditionally.
