¼ryr¼ r z uz · ¼ryr¼ r z uz rsr ÂÅÑÒÍÈÊ ÕÈÐÓÐÃÈÈ ÊÀÇÀÕÑÒÀÍÀ BULLETIN OF SURGERY IN KAZAKHSTAN ¹ 3 (44) 2015 Èçäàåòñÿ ñ 2005 ã. ISSN

ÂÅÑÒÍÈÊ ÕÈÐÓÐÃÈÈ

ÊÀÇÀÕÑÒÀÍÀ

BULLETIN OF SURGERY

IN KAZAKHSTAN

¹ 3 (44) 2015

ISSN 2306-5559 (print)

ISSN 2410-938X (online)

ÂÅÑÒÍÈÊ ÕÈÐÓÐÃÈÈ ÊÀÇÀÕÑÒÀÍÀ

BULLETIN OF SURGERY IN KAZAKHSTAN

¹ 3 (44) 2015

Èçäàåòñÿ ñ 2005 ã.

ISSN 2306-5559 (print)

ISSN 2410-938X (online)

EDITOR IN CHIEF

Arzykulov Zh.A.,

DEPUTY

CHIEF EDITOR

Medeubekov U.Sh.,

dr. med., prof.

Ñåéñåìáàåâ Ì.À., Æóðàåâ Ø.Ø., Ìèåðáåêîâ Å.Ì., Èæàíîâ Å.Á., Øèðòàåâ Á.Ê.,

Ìóðàäîâ Ì.È., Åíèí Å.À..

Ñåéñåìáàåâ Ì.À., Æóðàåâ Ø.Ø., Ìèåðáåêîâ Å.Ì., Èæàíîâ Å.Á., Øèðòàåâ Á.Ê.,

Áàèìáåòîâ À.Ê.,

Ìóðàäîâ Ì.È., Åíèí Å.À..

EDITORIAL BOARD

Seisembayev Ì.À., Zhurayev Sh.Sh., Mierbekov Ye.Ì., Izhanov Ye.B., Shirtaev B.Ê., Kospanov N.À., Baimbetov À.Ê., Toksanbayev D.S., Muradov Ì.I., Yenin Å.À..

ÁÀÑ ÐÅÄÀÊÒÎÐ

Ìåäåóáåêîâ ¦.Ø.,

ì.ƒ.ä., ïðîôåññîð

ÇÀÌÅÑÒÈÒÅËÜ

ÃËÀÂÍÎÃÎ ÐÅÄÀÊÒÎÐÀ

Ìåäåóáåêîâ Ó.Ø.,

ä.ì.í., ïðîôåññîð

Susumu Eguchi

Wojciech Polak

Remzi Emiroglu

Bulent Oktay

Tamer Turan

Jeong Tae Kim

Âëàäèìèð Âèøíåâñêèé

Èâàí Ñòèëèäè

Îëåã Ðóììî

Hannu Kuokkanen

Ho-Seong Han

Mehmet Habera

Ìèãåððàìàëè Ìàìåäîâ

N.J. Lygidakis

Åíèí Å.À.

ÐÅÄÀÊÖÈÎÍÍÛÉ ÑÎÂÅÒ

Susumu Eguchi

Wojciech Polak

Remzi Emiroglu

Bulent Oktay

Tamer Turan

Jeong Tae Kim

Âëàäèìèð Âèøíåâñêèé

Èâàí Ñòèëèäè

Îëåã Ðóììî

Hannu Kuokkanen

Ho-Seong Han

Mehmet Habera

Ìèãåððàìàëè Ìàìåäîâ

N.J. Lygidakis

Yenin E.A.

EDITORIAL COUNCIL

Susumu Eguchi

Wojciech Polak

Remzi Emiroglu

Bulent Oktay

Tamer Turan

Jeong Tae Kim

Vladimir Vishnevsky

Ivan Stilidi

Oleg Rummo

Hannu Kuokkanen

Ho-Seong Han

Mehmet Habera

Migerramali Mamedov

N.J. Lygidakis

Æóðíàë çàðåãèñòðèðîâàí â Ìèíèñòåðñòâå èíôîðìàöèè, êóëüòóðû è ñïîðòà ÐÊ.

Ðåãèñòðàöèîííûé íîìåð:Âëàäåëåö æóðíàëà

Àäðåñ ðåäàêöèè:

Äèçàéí è âåðñòêà:ÄÀÍ ËÅÍÊÎ

Òèðàæ Îòâåòñòâåííîñòü çà ñîäåðæàíèå

ïóáëèêóåìûõ ìàòåðèàëîâ íåñóò àâòîðû.

Ìèíèñòðë³ã³íäå ò³ðêåëãåí. Ò³ðêåó íµì³ð³

Æóðíàëäûœ èåñ³

Áàñïàíûœ ìåêåí-æàéû:

ÄÀÍ ËÅÍÊÎ

Òàðàëûìà

àâòîðëàð æàóàïòû.

The journal is registered with the Ministry of Information, Culture and Sports of the Republic of Kazakhstan. Registration number:

The owner of the journal

Editorial address:

Design and lead out:ÄÀÍ ËÅÍÊÎ

Edition The authors are responsible for the content of

published materials.

Ïîäïèñíîé èíäåêñ ÊÀÇÏÎ×ÒÛ – 75327 Subscript index of KAZPOST – 75327

CONTENTSÑÎÄÅÐÆÀÍÈÅ

Àðçûêóëîâ Æ.À., Ìåäåóáåêîâ Ó.Ø.,

Øîïøåêáàåâà Ñ.Ø.

Àíàëèç ñîñòîÿíèÿ è ïåðñïåêòèâû

âûñîêîñïåöèàëèçèðîâàííîé

ìåäèöèíñêîé ïîìîùè

â Ðåñïóáëèêå Êàçàõñòàí . . . . . . . . . . . .5

Äæóìàáåêîâ À.Ò., Àáóîâ Ñ.Ì., Æàðìåíîâ Ñ.Ì.,

Êàëûìáåòîâ Ð.Á., Æîðàåâ Ò.Ñ.,

Àðòûêáàåâ À.Æ.

Ñèìóëÿöèîííîå îáó÷åíèå íà òðåíàæåðå

LapSim . . . . . . . . . . . . . . . . . . . . . . . . . . 9

ÄÈÀÃÍÎÑÒÈÊÀ

Àëåêïåðîâà Ø.Í., Øàõâåðäèåâ È.Í.

Ñâÿçü ðàêà ñ äîìèíàíòíûì óçëîì ó

áîëüíûõ, êîòîðûì ïðîâåäåíà òîòàëüíàÿ

òèðåîèäýêòîìèÿ ïî ïîâîäó óçëîâîãî

çîáà è óñòàíîâëåí äèàãíîç: ðàê ùèòî-

âèäíîé æåëåçû . . . . . . . . . . . . . . . . 13

Àëûáàåâ Ý.Ó., Àøèðêóëîâ Ç.Ò., Àëûáàåâ Ì.Ý.

Ýíäîñêîïè÷åñêàÿ êàðòèíà îïåðèðî-

âàííîãî æåëóäêà, îñëîæíåííîãî ïåð-

ôîðàöèåé ïîñëå ðàçëè÷íûõ âàðèàíòîâ

îïåðàòèâíîãî âìåøàòåëüñòâà â ðàííåì

ïîñëåîïåðàöèîííîì ïåðèîäå. . . . . . . 18

Åíèí Å., Ïèñìàðåâà À.

×ðåñêîæíàÿ òîíêîèãîëüíàÿ áèîïñèÿ

ïðè äèàãíîñòèêå äèñôóíêöèè

ïî÷å÷íîãî òðàíñïëàíòàòà:

íàø îïûò

ïðèìåíåíèÿ Banff-êëàññèôèêàöèè . . . 21

Çàâüÿëîâà Ì.Þ.

ÌÐ-ýíòåðîãðàôèÿ ïðè

áîëåçíè Êðîíà. . . . . . . . . . . . . . . . . .25

Ãóñåéíîâ À.Â.

Ïðîôèëàêòèêà ãíîéíî-âîñïàëèòåëüíûõ

îñëîæíåíèé ïîñëå õîëåöèñòýêòîìèè

ïðè êîðè÷íåâûõ êàìíÿõ â æåë÷íîì

ïóçûðå ñ äåñòðóêòèâíûìè

èçìåíåíèÿìè. . . . . . . . . . . . . . . . . . .29

Êàñóìîâ Í.À., Ìàìåäîâ Ì.Ì., Ìàìåäîâ Ø.Ê.

Ýôôåêòèâíîñòü ïðèìåíåíèÿ íèçêîèí-

òåíñèâíîãî ëàçåðíîãî èçëó÷åíèÿ â ñî÷å-

òàíèå ñ àíòèîêñèäàíòîì-àðãîñóëüôàíîì

ïðè òåðìè÷åñêîì îæîãå êîæè . . . . . . .35

Ìóðàäîâ Ì.È., Ñàéê Ï.Þ., Ñàäûêîâ Ò.À.,

Ìóõàìåäêåðèì Ê.Á., Áàéãóçåâà À.À.

Îïûò ìèêðîõèðóðãè÷åñêîãî ëå÷åíèÿ

äåôåêòîâ êîñòåé ïðåäïëå÷üÿ ïóòåì ïðè-

ìåíåíèÿ âàñêóëÿðèçèðîâàííîãî ìàëîáåð-

öîâîãî àóòîòðàíñïëàíòàòà. . . . . . . . . . . 41

HEALTH CARE ORGANIZATION

Arzykulov Zh.A., Medeubekov U.Sh.,

Shopshekbayeva S.Sh.

Analysis of the status

and prospects

of tertiary care

in the Republic of Kazakhstan. . . . . . . .5

Djumabekov A.T., Zhoraev T.S., Artykbaev A.J.,

Abuov S.M., Zharmenov S.M.,

Kalymbetov R.B.

Simulation training on the LapSim

simulator . . . . . . . . . . . . . . . . . . . . . . . . . 9

DIAGNOSTICS

Akekperova Sh.I., Shakhverdiyev I.N.

The association of cancer with

dominant node in patients

with total thyroidectomy for

node goiter and establishment

of thyroid cancer. . . . . . . . . . . . . . . . . 13

Alybayev E.U., Ashirkulov Z.T., Alybayev M.E.

Endoscopic picture of ventricle

operated with complicated perforation

after various options of operative

intervention in the early postoperative

period . . . . . . . . . . . . . . . . . . . . . . . . 18

Enin E., Pismareva A.

Percutaneous needle core biopsy

at diagnostics of renal allograft

dysfunction: our experience

in application

of Banff-classification. . . . . . . . . . . . . 21

Zavyalova Ì.Y.

of Crohn’s disease . . . . . . . . . . . . . . .25

SURGERY

Guseinov A.V.

Prevention of pyoinflammatory

complications after

cholecystectomy for brown stones

in the gallbladder with destructive

changes . . . . . . . . . . . . . . . . . . . . . . .29

Kasumov N.A., Mamedov M.M., Mamedov Sh.K.

Efficiency of application low intensity

laser radiation in combination with

antioxidants - argosulphan at thermal burn

of skin . . . . . . . . . . . . . . . . . . . . . . . .35

Muradov M., Saik P., Sadykov T.,

Mukhamedkerim K., Bayguzeva A.

Experience of microsurgical

treatment of bone defects by

applying a forearm vascularized

fibular autograft . . . . . . . . . . . . . . . . . . . 41

Øµïøåêáàåâà Ñ.Ø.

ïåðñïåêòèâàëàðû . . . . . . . . . . . . . . . .5

LapSim òðåíàæåðäåãi ñèìóëÿöèÿñû

‰éðåòóëåði. . . . . . . . . . . . . . . . . . . . . . . . 9

ÄÈÀÃÍÎÑÒÈÊÀ


íûñû. . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Åðòå îïåðàöèÿäàí êåé³íã³ ìåðç³ìäå

. . 18


Á‰éðåêò³ òðàíñïëàíòàòòàó äèôóíêöèÿñûí

äèàãíîñòèêàëàó êåç³íäåã³ òåð³àñòû

. . . . . . . . . . . . . . . . . . . . 21


ýíòåðîãðàôèÿñû . . . . . . . . . . . . . . . .25


Äåñòðóêòèâò³ µçãåð³ñòåð³ìåí µò

-

ôèëàêòèêàñû . . . . . . . . . . . . . . . . . . .29


-

. . . . . . . . . . .35

åìäåó³ . . . . . . . . . . . . . . . . . . . . . . . . 41

3BULLETIN OF SURGERY IN KAZAKHSTAN

Ìóñëèìîâ Ã.Ô., Þñèôîâà À.Í., Àëèåâà Ã.Ð.

ãàñòîýçîôàãåàëäû ðåôëþêñòû àóðóäû

ôóíäîïëèêàöèÿëàó. . . . . . . . . . . . . . .47

Ñàƒàòîâ ².Å., Àáäèëîâà Ã.Á., Áåðäèìóðàòîâà Æ.Ñ.

äèíàìèêàñû. . . . . . . . . . . . . . . . . . . .55

Ïàíãèðååâ Ä.Ä.

. . . . . . . . 59

Ãàñàíîâ Ô.Ä., Àñëàíîâ À.À., Íàìàçîâà Ê.Í.,

Àááàñîâà Ì.Ò., Àñêåðîâà Ã.À., Ìóñàåâà Í.Ç.,

Êåðèìîâà Ã.Ì.

. . 63

ÏÐÅÏÀÐÀÒÒÀÐ

ôóíêöèÿñû . . . . . . . . . . . . . . . . . . . .70


Ëàïàðîñêîïè÷åñêàÿ ôóíäîïëèêàöèÿ ïî

Íèññåíó â àðñåíàëå õèðóðãè÷åñêîãî ëå-

÷åíèÿ ãàñòîýçîôàãåàëüíîé ðåôëþêñíîé

áîëåçíè, îñëîæíåííîé Áàððåòò-ýçîôà-

ãèòîì. . . . . . . . . . . . . . . . . . . . . . . . .47

Ñàãàòîâ È.Å., Àáäèëîâà Ã.Á., Áåðäèìóðàòîâà Æ.Ñ.

Äèíàìèêà of u-NGAL ó ïàöèåíòîâ êàð-

äèîõèðóðãè÷åñêîãî ïðîôèëÿ â ðàííåì

ïîñëåîïåðàöèîííîì ïåðèîäå. . . . . . .55

Äåìåóîâ Ò.Í., Àêàíîâ Å.Ê., Ìàòêåðèìîâ À.Æ.,

Æàêóáàåâ Ì.À., Òåðãåóñèçîâ À.Ñ.,

Ïàíãèðååâ Ä.Ä.

Ýíäîâàñêóëÿðíàÿ õèðóðãèÿ ðåíîâàñêóëÿð-

íîé ãèïåðòåíçèè . . . . . . . . . . . . . . . . . . 59

Ãàñàíîâ Ô.Ä., Àñëàíîâ À.À., Íàìàçîâà Ê.Í.,

Àááàñîâà Ì.Ò., Àñêåðîâà Ã.À., Ìóñàåâà Í.Ç.,

Êåðèìîâà Õ.Ì.

Êîððåëÿòèâíàÿ ñâÿçü êëèíèêè êîìáèíè-

ðîâàííîé èíòóáàöèîííîé ýïèäóðàëüíîé

àíåñòåçèè ñ òèïîì âåãåòàòèâíîé íåðâíîé

ñèñòåìû . . . . . . . . . . . . . . . . . . . . . .63

Êàëêàáàåâ Æ.Ê., Íóðãîæèí Å.À., Èáðàåâà Ñ.Å.,

Áàéìóõàíîâ Ð.Ì., Êèñïàåâà Ò.Ò.

Ïðåâåíòèâíî – òåðàïåâòè÷åñêàÿ êîððåê-

öèÿ êîãíèòèâíîé ñôåðû ó áîëüíûõ

â îñòðîì ïåðèîäå öåðåáðàëüíîãî èí-

ñóëüòà . . . . . . . . . . . . . . . . . . . . . . . .70

Muslimov G.F, Yusifova A.N., Aliyeva G.R.

Laparoscopic nissen fundoplication

in the treatment of

gastroesophageal reflux

disease complicated Barrett’s

esophagus . . . . . . . . . . . . . . . . . . . . .47

Sagatov I.Ye., Abdilova G.B., Berdimuratova Zh.S.

Dynamic of u-NGAL in cardiac

surgical patients in the early

postoperative period . . . . . . . . . . . . . .55

Khanchi Ì., Kospanov N.A., Ormanov B.K.,

Demeuov T.N., Akanov E.K., Matkerimov A.Zh.,

Zhakubayev M.A., Tergeussizov A.S.,

Pangireyev D.D.

The endovascular surgery of renovascular

hypertension . . . . . . . . . . . . . . . . . . . . . 59

ANESTHESIOLOGY AND INTENSIVE CARE

Hasanov F.D., Aslanov A.A., Namazova K.N.,

Abbasova M.T., Askerova G.A., Musayeva N.Z.,

Kerimova H.M.

Correlative links of clinics of

combined epidural endotracheal

anesthesia with type of autonomic

nervous system . . . . . . . . . . . . . . . . .63

DRUGS

Kalkabaev J.C., Nurgozhin E.A., Ibrayeva S.E.,

Baimukhanov R.M., Kispaeva T.T.

The preventive-therapeutic

correction of cognitive

sphere in the acute period

of cerebral stroke . . . . . . . . . . . . . . . .70

CONTENTSÑÎÄÅÐÆÀÍÈÅ

ÂÅÑÒÍÈÊ ÕÈÐÓÐÃÈÈ ÊÀÇÀÕÑÒÀÍÀ 4

BULLETIN OF SURGERY IN KAZAKHSTAN 5

ÏÎÌÎÙÈ Â ÐÅÑÏÓÁËÈÊÅ ÊÀÇÀÕÑÒÀÍ

Àííîòàöèÿ

Â ñâÿçè, âî èñïîëíåíèå Ãîñóäàðñòâåííîé ïðîãðàììû ðàçâèòèÿ çäðàâîîõðàíåíèÿ ÐÊ «Ñàëàìàòòû

Êàçàõñòàí» ðàçðàáîòàíà Êîíöåïöèÿ ðàçâèòèÿ âûñîêîñïåöèàëèçèðîâàííîé ìåäèöèíñêîé ïîìîùè íà

2011-2015 ãîäû, öåëüþ êîòîðîé ÿâëÿåòñÿ ðåàëèçàöèÿ ìåðîïðèÿòèé ïî îáåñïå÷åíèþ ãðàæäàí ñòðàíû

äîñòóïíîé è êà÷åñòâåííîé ÂÑÌÏ, îñíîâàííîé íà ìåæäóíàðîäíûõ ñòàíäàðòàõ êà÷åñòâà è áåçîïàñíîñòè.

Â èòîãå, ðåàëèçàöèÿ ìåðîïðèÿòèé Êîíöåïöèè ïîçâîëèò ðåøèòü ïðîáëåìíûå âîïðîñû ÂÑÌÏ: óñîâåð-

øåíñòâîâàòü îðãàíèçàöèþ îêàçàíèÿ è ðàñøèðèòü òðàíñôåðò ÂÑÌÏ â ðåãèîíû, ñîçäàòü ñèñòåìó îòáîðà

òåõíîëîãèé ÂÑÌÏ ñ äîêàçàííîé ýôôåêòèâíîñòüþ è áåçîïàñíîñòüþ èõ ïðèìåíåíèÿ, ïîâûñèòü êîîðäè-

íèðóþùóþ è íàïðàâëÿþùóþ ðîëü ïðîôèëüíûõ ÍÈÈ, ÍÖ è ÂÓÇîâ â ðàçâèòèè ñèñòåìû ÂÑÌÏ..

Êëþ÷åâûå ñëîâà âûñîêîñïåöèàëèçèðîâàííàÿ

ìåäèöèíñêàÿ ïîìîùü,

òðàíñôåðò òåõíîëîãèé,

õèðóðãè÷åñêàÿ ñëóæáà.

Àðçûêóëîâ Æ.À., Ìåäåóáåêîâ Ó.Ø., Øîïøåêáàåâà Ñ.Ø.

-

-

Abstract

In this regard, pursuant to the State program of Health of Kazakhstan «Salamatty Kazakhstan» Concept

of development of tertiary care for 2012-2015, the purpose of which is to implement measures to ensure

its citizens affordable and high-quality tertiary care, based on international standards of quality and safety.

As a result, the implementation of the Concept will allow to solve the problematic issues of tertiary care: to

improve the organization and expand the provision of tertiary care in the regions of the transfer, create a

system of screening technology tertiary care with proven efficacy and safety of their application, to improve

coordination and guiding role of specialized research institutes, universities and NC in the development of

tertiary care .

Analysis of the status and prospects of tertiary care in the Republic of Kazakhstan

Ò‰é³í ñµçäåðæîƒàðû ìàìàíäàíäûðûëƒàí

òåõíîëîãèÿëàðäû òðàíñôåðòòåó,

Key words highly specialized medical assistance, technology transfer, the surgical service.

ÎÁ ÀÂÒÎÐÀÕ:

-

âè÷ – Ïðåäñåäàòåëü ïðàâëåíèÿ

ä.ì.í., ïðîôåññîð, àêàäåìèê

ÍÀÍ ÐÊ;

-

ðîâè÷ – çàìåñòèòåëü ïðåä-

èì. À.Í. Ñûçãàíîâà», ä.ì.í.,

ïðîôåññîð;

– çàâåäóþùàÿ

ÍÍÖÕ èì. Ñûçãàíîâà, âðà÷ âûñ-

øåé êàòåãîðèè.

-

- «À.Í. Ñûçƒàíîâ

ïðîôåññîð;

- À.Í.

ABOUT THE AUTHORS:

Zhetkergen A. Arzykulov

- Chairman of the Board of

JSC «NSCS named after A.N.

Syzganov», dr. med., professor,

academician of NAS RK;

Ulukbek Sh. Medeubekov -

Deputy Chairman of the Board

of JSC “NSCS named after A.N.

Syzganov”, dr. med., professor;

Semeigul Sh. Shopshekbayeva

– Head of the NSCS n/a Syzganov,

a high level certificate physician.


Âñåãî ïðîëå÷åíî

áîëüíûõèç íèõ ÂÑÌÏ â %

2013 2014 2013 2014 2013 2014

Ðåñïóáëèêà Êàçàõñòàí

Àêìîëèíñêàÿ

Àêòþáèíñêàÿ

Àëìàòèíñêàÿ

Àòûðàóñêàÿ

Â-Êàçàõñòàíñêàÿ

Æàìáûëñêàÿ

Ç-Êàçàõñòàíñêàÿ

Êàðàãàíäèíñêàÿ

Êûçûëîðäèíñêàÿ

Êîñòàíàéñêàÿ

Ìàíãèñòàóñêàÿ

Ïàâëîäàðñêàÿ

Ñ-Êàçàõñòàíñêàÿ

Þ-Êàçàõñòàíñêàÿ

ã. Àëìàòû

ã. Àñòàíà

Òàáëèöà 1


Ðèñóíîê 1.

Âûâîäû

Îðãàíèçàöèÿ ÂÑÌÏ (àáñ. ÷èñ.) ÂÑÌÏ (%)

ã. Àëìàòû

ã. Àñòàíà

Âñåãî:

Òàáëèöà 2


Ëèòåðàòóðà References


Àííîòàöèÿ

Â ñòàòüå ïðåäñòàâëåíî ýôôåêòèâíîñòü ñèìóëÿöèîííîãî îáó÷åíèÿ íà òðåíàæåðå LapSim. Íàìè áûëè èç-

ó÷åíû èñòîðèè áîëüíûõ ïîñòóïèâøèõ â ïëàíîâîì ïîðÿäêå íà ëàïàðîñêîïè÷åñêóþ õîëåöèñòýêòîìèþ. 2011-

2012 ãã èçó÷åíî 18 èñòîðèé áîëåçíåé, ãäå 3 ðåçèäåíòîâ âûïîëíÿëè àññèñòèðîâàíèå íà ëàïàðîñêîïè÷åñêîé

õîëåöèñòýêòîìèè áåç ïðåäâàðèòåëüíîãî îáó÷åíèÿ íà âèðòóàëüíîì ñèìóëÿòîðå LapSim. 2013-2014 ãã èçó÷åíî

16 èñòîðèé áîëåçíåé, ãäå 3 ðåçèäåíòîâ âûïîëíÿëè àññèñòèðîâàíèå íà ëàïàðîñêîïè÷åñêîé õîëåöèñòýêòîìèè

ñ ïðåäâàðèòåëüíûì îáó÷åíèåì íà âèðòóàëüíîì ñèìóëÿòîðå LapSim. Èñïîëüçîâàíèå âèðòóàëüíîãî òðåíàæå-

ðà-ñèìóëÿòîðà LapSim® â ó÷åáíîì ïðîöåññå ñóùåñòâåííî, â 2-3 ðàçà ñíèæàåò êîëè÷åñòâî îøèáîê, êîòîðûå

äîïóñêàþò íà÷èíàþùèå õèðóðãè ïðè âûïîëíåíèè ñâîèõ ïåðâûõ ëàïàðîñêîïè÷åñêèõ îïåðàöèé.

Êëþ÷åâûå ñëîâà ñèìóëÿöèîííîå îáó÷åíèå,

âèðòóàëüíûé òðåíàæåð, LapSim.

Äæóìàáåêîâ À.Ò., Àáóîâ Ñ.Ì., Æàðìåíîâ Ñ.Ì., Êàëûìáåòîâ Ð.Á., Æîðàåâ

Ò.Ñ., Àðòûêáàåâ À.Æ..

-

Abstract

The article presents the effectiveness of simulation training on the LapSim simulator. We studied the history

of patients enrolled in a planned manner for laparoscopic cholecystectomy. 2011-2012 studied 18 of case

histories where 3 residents performed assisting at laparoscopic cholecystectomy without prior training on virtual

simulator LapSim. 2013-2014 studied 16 case histories where 3 residents performed assisting at laparoscopic

cholecystectomy with pre-training on virtual simulator LapSim. The use of virtual simulator LapSim® in the learning

process considerably, 2-3 times reduces the number of mistakes made by novice surgeons in the performance of

their first laparoscopic operations.

LapSim òðåíàæåðäåãi ñèìóëÿöèÿñû ‰éðåòóëåði

Simulation training on the LapSim simulator

Kalymbetov R.B.

Ò‰é³í ñµçäåð

æàòòûƒó, LapSim.

Key words simulation training, virtual trainer, LapSim.

ABOUT THE AUTHORS:

Àueskhan T. Djumabekov - head of the

Department of Surgery with the course of Thoracic

Surgery and Coloproctology of the KazMUCE,

e-mail: [email protected], tel. 87017414437;

Sapar M. Abuov - Associate Professor of Surgery

Department with the course of Thoracic Surgery

and Coloproctology of the KazMUCE, e-mail:

[email protected], tel. 87013720109;

Samat M. Zharmenov - Associate Professor of

Surgery Department with the course of Thoracic



Rakhmanberdi B. Kalymbetov - Associate

Professor of Surgery Department with the course

of Thoracic Surgery and Coloproctology of the

KazMUCE, e-mail: [email protected], tel.

87076835072;

Tagabai S. Zhoraev - Associate Professor of

Surgery Department with the course of Thoracic



Adilbek J. Artykbaev - assistant of Surgery

Department with the course of Thoracic Surgery

and Coloproctology of the KazMUCE, e-mail:

[email protected], ñîò. òåë. 87026902995.

[email protected], òåë. 87017414437;



-

-

e-mail: [email protected], òåë. 87076835072;


[email protected], òåë. 87026902995.


– Àëìàòèíñêèé

ãîñóäàðñòâåííûé èíñòèòóò óñîâåðøåíñòâîâàíèÿ

âðà÷åé, çàâåäóþùèé êàôåäðîé õèðóðãèè ñ êóðñàìè

òîðàêàëüíîé õèðóðãèè è êîëîïðîêòîëîãèè, e-mail:


- Àëìàòèíñêèé ãîñó-

äàðñòâåííûé èíñòèòóò óñîâåðøåíñòâîâàíèÿ âðà÷åé,

äîöåíò êàôåäðû õèðóðãèè ñ êóðñàìè òîðàêàëüíîé

õèðóðãèè è êîëîïðîêòîëîãèè, e-mail: hirurgia.agiuv@

mail.ru, òåë. 87013720109;

- Àëìàòèíñêèé


âðà÷åé, äîöåíò êàôåäðû õèðóðãèè ñ êóðñàìè



- Àëìà-

òèíñêèé ãîñóäàðñòâåííûé èíñòèòóò óñîâåðøåíñòâî-

âàíèÿ âðà÷åé, äîöåíò êàôåäðû õèðóðãèè ñ êóðñàìè



– Àëìàòèíñêèé


âðà÷åé, äîöåíò êàôåäðû õèðóðãèè ñ êóðñàìè òîðà-

êàëüíîé õèðóðãèè è êîëîïðîêòîëîãèè, e-mail: hirurgia.


- Àëìàòèíñêèé


âðà÷åé, àññèñòåíò êàôåäðû õèðóðãèè ñ êóðñàìè


[email protected], òåë. 87026902995.



Ëèòåðàòóðà


References


II. ÄÈÀÃÍÎÑÒÈÊÀ

Àííîòàöèÿ

Ðåçóëüòàòû èññëåäîâàíèÿ ïîêàçûâàþò, ÷òî â ñëó÷àå ïðîâåäåíèÿ òîíêîèãîëüíîé àñïèðàöèîííîé

ïóíêöèîííîé áèîïñèè (ÒÀÏÁ) òîëüêî â äîìèíàíòíîì óçëå áîëüøå ïîëîâèíû î÷àãîâ ðàêà ùèòîâèäíîé

æåëåçû, à â ñëó÷àå ïðîâåäåíèÿ ëîáýêòîìèè òîëüêî â äîëå äîìèíàíòíîãî óçëà îäíà òðåòüÿ î÷àãîâ ìîæåò

áûòü ïðîïóùåíà. Áûëî âûñêàçàíî ïðåäïîëîæåíèå î öåëåñîîáðàçíîñòè ïðîâåäåíèÿ ÒÀÏÁ, ïî êðàéíåé

ìåðå, åùå îäíîãî ïîäîçðèòåëüíîãî óçëà ïîìèìî äîìèíàíòíîãî (îñîáåííî â ñëó÷àå, åñëè â ïðîòèâî-

ïîëîæíîé äîëå èìååòñÿ ïîäîçðèòåëüíûé óçåë), à òàêæå ïðèíÿòèÿ âî âíèìàíèå òîòàëüíîé òèðåîèäýê-

òîìèè èç-çà âûñîêîé âåðîÿòíîñòè ìíîãîî÷àãîâîñòè ó áîëüíûõ ñ ïîäîçðåíèåì íà ïàïèëëÿðíûé ðàê.

Êëþ÷åâûå ñëîâà äîìèíàíòíûé óçåë, ðàê

ùèòîâèäíîé æåëåçû, òîòàëüíàÿ

òèðåîèäýêòîìèÿ.


Abstract

The findings show that in case of thin-needle aspiration paracentetic biopsy (TAPB) administration in

dominant node there are more than half of thyroid cancer foci may be omitted. In case of lodectomy only

in the lobe of dominant node 1/3 of foci may be omitted. It is proposed a policy led to the administration of

TAPB, at least in more than one suspected node except dominant (especially in case if there is a suspicious

node in the opposite side). And it is also important to consider total thyroidectomy because of high evidence

of multifocal cases in patients with suspicious papillary cancer.

îáûðìåí áàéëàíûñû

The association of cancer with dominant node in patients with total thyroidectomy for

node goiter and diagnose of thyroid cancer


Akekperova Sh.I., Shakhverdiyev I.N.


æàñàó.

Key words Dominant nodule, thyroid cancer, total thyroidectomy.


êûçû,

ABOUT THE AUTHORS:

Shakhla I. Alekperova,


Ââåäåíèå

Öåëüþ èññëåäîâàíèÿ

Ìàòåðèàë è ìåòîäû:

Ïîëó÷åííûå ðåçóëüòàòû:

±

±

±


Îáñóæäåíèå ïîëó÷åííûõ ðåçóëüòàòîâ:




References


Keywords ventricle, endoscopy, stenosing

ulcer, pyloroduodenoplasty,

perforation.


æàðà, ïèëîðîäóîäåíîïëàñòèêà,

ïåðôîðàöèÿ.

Êëþ÷åâûå ñëîâàæåëóäîê, ýíäîñêîïèÿ, ñòåíîçè-

ðóþùàÿ ÿçâà, ïèëîðîäóîäåíî-

ïëàñòèêà, ïåðôîðàöèÿ.

ENDOSCOPIC PICTURE OF VENTRICLE OPERATED

VARIOUS OPTIONS OF OPERATIVE INTERVENTION

IN THE EARLY POSTOPERATIVE PERIOD


Abstract

The results of endoscopic assessment of state of the operated ventricle in patients with stenosing ulcer,

combined with perforations, in the early stages after surgery showed that one of the main reasons for

motor-evacuation function of the stomach after palliative and radical surgery is the development of an acute

inflammatory response in the area of pyloroduodenoplasty or sutured ulcer. Therefore, the technique and

choice of operating patients in this group have a great influence on the postoperative course and condition

of evacuation function of the stomach.

-

-

Àííîòàöèÿ

Ïîëó÷åííûå ðåçóëüòàòû ýíäîñêîïè÷åñêîé îöåíêè ñîñòîÿíèÿ îïåðèðîâàííîãî æåëóäêà ó áîëüíûõ

ñòåíîçèðóþùåé ÿçâîé, ñî÷åòàþùåéñÿ ñ ïåðôîðàöèåé, â ðàííèå ñðîêè ïîñëå îïåðàòèâíîãî âìåøà-

òåëüñòâà ïîêàçàëè, ÷òî îäíîé èç ãëàâíûõ ïðè÷èí ìîòîðíî-ýâàêóàòîðíîé ôóíêöèè æåëóäêà ïîñëå ïàëè-

àòèâíûõ è ðàäèêàëüíûõ îïåðàöèé ÿâëÿåòñÿ ðàçâèòèå îñòðîé âîñïàëèòåëüíîé ðåàêöèè â çîíå ïèëîðî-

äóîäåíîïëàñòèêè èëè óøèòîé ÿçâû. Ñëåäîâàòåëüíî, òåõíèêà è âûáîð ìåòîäà îïåðèðîâàíèå ó áîëüíûõ

ýòîé ãðóïïû îêàçûâàþò áîëüøîå âëèÿíèå íà ïîñëåîïåðàöèîííîå òå÷åíèå è ñîñòîÿíèå ýâàêóàòîðíîé

ôóíêöèè æåëóäêà.

Ýíäîñêîïè÷åñêàÿ êàðòèíà îïåðèðîâàííîãî æåëóäêà îñëîæíåííîé ïåðôîðàöèåé

ïîñëå ðàçëè÷íûõ âàðèàíòîâ îïåðàòèâíîãî âìåøàòåëüñòâ â ðàííåì

ïîñëåîïåðàöèîííîì ïåðèîäå

Àëûáàåâ Ý.Ó., Àøèðêóëîâ Ç.Ò., Àëûáàåâ Ì.Ý.

ABOUT THE AUTHORS:

Ernis U. Alybaev - head of the

surgical department of the NSC of

KR, dr. med., prof.,

e-mail: [email protected],

tel. 0312218890.


- çà-

âåäóþùèé õèðóðãè÷åñêèì îòäåëå-

íèåì ÍÖÕ ÊÐ, ä.ì.í., ïðîôåññîð,


òåë. 0312218890


òåë. 0312218890



References


Keywords renal allograft biopsy, related

transplantations, renal allograft

rejection, lifetime morphological

research.

Ò‰é³í ñµçäåð-

-

-

ãíîñòèêàñû.

Êëþ÷åâûå ñëîâàáèîïñèÿ ïî÷å÷íîãî òðàíñïëàí-

òàòà, ðîäñòâåííàÿ òðàíñ-

ïëàíòàöèÿ, êðèçû îòòîðæåíèÿ

ïî÷å÷íîãî òðàíñïëàíòàòà, ïðè-

æèçíåííàÿ ìîðôîëîãè÷åñêàÿ

äèàãíîñòèêà.

PERCUTANEOUS NEEDLE CORE BIOPSY

AT DIAGNOSTICS OF RENAL ALLOGRAFT

DYSFUNCTION: OUR EXPERIENCE IN APPLICATION

OF BANFF-CLASSIFICATION


Abstract

In the given publication the results of researches showing a share and character of morphological

changes in kidneys with application of Banff-classification at lifetime morphological diagnostics of renal

allograft rejection are reflected. Research is carried out by studying bioptates in 31 cases at allograft

rejection at related transplantation of a kidney.

Enin E., Pismareva A.

Àííîòàöèÿ

Â äàííîé ïóáëèêàöèè îòðàæåíû ðåçóëüòàòû èññëåäîâàíèé, äåìîíñòðèðóþùèå äîëþ è õàðàêòåð

ìîðôîëîãè÷åñêèõ èçìåíåíèé â ïî÷êàõ ñ ïðèìåíåíèåì Banff-êëàññèôèêàöèè ïðè ïðèæèçíåííîé ìîð-

ôîëîãè÷åñêîé äèàãíîñòèêå êðèçîâ îòòîðæåíèÿ òðàíñïëàíòàòà. Èññëåäîâàíèå ïðîâåäåíî ïóòåì èçó÷å-

íèÿ áèîïòàòîâ â 31 ñëó÷àå êðèçîâ îòòîðæåíèÿ ïðè ðîäñòâåííîé òðàíñïëàíòàöèè ïî÷êè.

Á‰éðåêò³ òðàíñïëàíòàòòàó äèôóíêöèÿñûí äèàãíîñòèêàëàó êåç³íäåã³ òåð³àñòû

×ðåñêîæíàÿ òîíêîèãîëüíàÿ áèîïñèÿ ïðè äèàãíîñòèêå äèñôóíêöèè ïî÷å÷íîãî

òðàíñïëàíòàòà: íàø îïûò ïðèìåíåíèÿ Banff-êëàññèôèêàöèè




–

çàâåäóþùèé ïàòîëîãîàíàòîìè÷å-

ñêîé ëàáîðàòîðèåé, âðà÷ âûñøåé

êàòåãîðèè, e-mail: [email protected]

-

ìèðîâíà – âðà÷-ïàòîëîãîàíàòîì,

e-mail: anastasiyapismareva@

mail.ru

ABOUT THE AUTHORS:

Evgeny A. Enin

ïàòîëîãàíàòîì


Fig. 1.

Fig. 2.

Fig.1.

Fig.1.


Fig. 3.

Fig. 4.

Fig. 5.

Fig.4.

Fig.5.


References



Àííîòàöèÿ

Áîëåçíü Êðîíà ÿâëÿåòñÿ õðîíè÷åñêèì èäèîïàòè÷åñêèì âîñïàëèòåëüíûì çàáîëåâàíèåì æåëóäî÷íî-êè-

øå÷íîãî òðàêòà. Ðàñïðîñòðàíåííîñòü áîëåçíè Êðîíà äîñòèãàåò 100-200 ñëó÷àåâ çà 100000 íàñåëåíèÿ â

Ñåâåðíîé Àìåðèêå è Åâðîïå. Âèçóàëèçàöèÿ ïàöèåíòîâ ñ áîëåçíüþ Êðîíà òðàäèöèîííî âêëþ÷àåò ñî÷åòà-

íèå êîëîíîñêîïèè ñ áèîïñèåé, ðåíòãåíîñêîïèè ñ áàðèåâîé âçâåñüþ è êîìïüþòåðíîé òîìîãðàôèè (ÊÒ). Ìàã-

íèòíî-ðåçîíàíñíàÿ (ÌÐÒ) òîìîãðàôèÿ ïîçâîëÿåò áûñòðîå ïîëó÷åíèå èçîáðàæåíèé êèøå÷íèêà ñ âûñîêèì

âûÿâëåíèÿ áîëåçíè Êðîíà. Ïðåèìóùåñòâîì ÌÐ-ýíòåðîãðàôèè ÿâëÿåòñÿ îòñóòñòâèå èîíèçèðóþùåãî èçëó-

÷åíèÿ, óëó÷øåííàÿ êîíòðàñòíîñòü ìÿãêèõ òêàíåé, è îòíîñèòåëüíî áåçîïàñíîå êîíòðàñòíîå âåùåñòâî äëÿ

âíóòðèâåííîãî ââåäåíèÿ. Ìåòîäèêà âûïîëíåíèÿ ÌÐ-ýíòåðîãðàôèè çàêëþ÷àåòñÿ âî ââåäåíèè êîíòðàñòíîãî

äîñòèæåíèÿ îïðåäåëåííîé ñòåïåíè ðàñòÿæåíèÿ êèøå÷íèêà. ÌÐÒ-ïðèçíàêè áîëåçíè Êðîíà - íåðàâíîìåðíîå

óòîëùåíèå ñòåíêè ïîðàæåííîé êèøêè, ñåãìåíòàðíîñòü ïîðàæåíèÿ, ðàññëîåíèå ñòåíêè êèøå÷íèêà ïðè âíó-

òðèâåííîì êîíòðàñòèðîâàíèè, èçìåíåíèÿ êðîâîòîêà ïî ñîñóäàì, âîñïàëèòåëüíûå èçìåíåíèÿ â áðûæåéêå,

ëèìôîàäåíîïàòèÿ è ñâèùè.

Êëþ÷åâûå ñëîâà ÌÐ-ýíòåðîãðàôèÿ, áîëåçíü

Êðîíà.

Çàâüÿëîâà Ì.Þ

-

-

ðàëàð.

Abstract

Crohn’s disease is a chronic idiopathic inflammatory disease of the gastrointestinal tract. Crohn disease has

a prevalence of around 100–200 per 100,000 people in North America and Europe. Imaging of patients with

Crohn disease traditionally has included a combination colonoscopy with biopsy, fluoroscopic and computed

tomographic (CT) techniques. Magnetic resonance (MR) imaging allows rapid acquisition of high-resolution

Crohn disease. Advantages of magnetic resonance (MR) imaging include a lack of ionizing radiation, improved

soft-tissue contrast, and a relatively safe intravenous contrast agent profile. Techniques for performing MR-

essential to achieve some degree of bowel distention. MRI sign of Crohn’s disease was irregular thickening

wall of the affected intestine, segmental lesions, stratification of intestine wall after intravenous contrast agent

application, changes of blood flow through the vessels and inflammatory changes of mesentery, lymphadenopathy

and fistulas were detected.

ÌÐ-ýíòåðîãðàôèÿñû

-enterography of Crohn’s disease


Zavyalova Ì.Y.

Ò‰é³í ñµçäåðÌÐ-ýíòåðîãðàôèÿ, Êðîí àóðóû.

Key words Dominant nodule, thyroid cancer, total thyroidectomy.


ABOUT THE AUTHORS:

Zavyalova M.Yu.


Ââåäåíèå

Öåëü ðàáîòû:

Ìàòåðèàëû è ìåòîäû èññëåäîâàíèÿ

Ðèñóíîê 1.

Ðèñóíîê 2.


Ðåçóëüòàòû è èõ îáñóæäåíèå

Ðèñóíîê 3.

Ðèñóíîê 4.

Ðèñóíîê 5.


Âûâîäû



Êëþ÷åâûå ñëîâàõîëåñòåðèíîâûå êàìíè, ÷åðíûå

êàìíè, êîðè÷íåâûå êàìíè,

æåë÷íûé ïóçûðü, öèððîç

ïå÷åíè.


áàóûð öèððîçû.

Keywords cholesterol stones, black stones,

brown stones, gall bladder, liver

cirrhosis.

Àííîòàöèÿ

èëè áèëèðóáèíà, èçìåíåíèåì ôèçèêî-õèìè÷åñêèõ ñâîéñòâ æåë÷è, à òàêæå ðàçâèòèåì âîñïàëèòåëüíîãî ïðîöåññà. Ïî ñî-

ñòàâó îïðåäåëÿþò 3 òèïà æåë÷íûõ êàìíåé: õîëåñòåðèíîâûå, ÷åðíûå ïèãìåíòíûå è êîðè÷íåâûå ïèãìåíòíûå. Õîëåñòåðè-

÷¸ðíîãî ïèãìåíòà, ôîñôàòà è êàðáîíàòà êàëüöèÿ áåç ïðèìåñåé õîëåñòåðèíà è ïðîÿâëÿþò ñåáÿ ïðè áîëåçíÿõ êðîâè,

ñîïðîâîæäàþùèõñÿ õðîíè÷åñêèì ãåìîëèçîì, ïðè öèððîçå è äðóãèõ õðîíè÷åñêèõ çàáîëåâàíèÿõ ïå÷åíè.

Àíàëèç ïðåäîïåðàöèîííûõ äàííûõ ó áîëüíûõ â íàøèõ ãðóïïàõ èññëåäîâàíèÿ äîêàçàë, ÷òî èíòåíñèâíîñòü ïàòîëîãè-

÷åñêîãî ïðîöåññà îòëè÷àëñÿ êëèíèêîé çàáîëåâàíèÿ îò áîëüíûõ ñ õîëåñòåðèíîâûìè êàìíÿìè. Êëèíè÷åñêèå íàáëþäåíèÿ

áûëè äîêàçàíû è îáîñíîâàíû àíàëèçàìè ëàáîðàòîðíûõ òåñòîâ è ðåçóëüòàòàìè ïàòîìîðôîëîãè÷åñêîãî èññëåäîâàíèÿ.

Èäåíòèôèêàöèÿ áîëüíûõ ñ êîðè÷íåâûìè êàìíÿìè, îòêðûâàåò âîçìîæíîñòè áîëåå èíäèâèäóàëüíî ïîäîéòè ê ýòîé

ïðîáëåìå. Ïðîâåäåííàÿ òðîéíàÿ àíòèáàêòåðèàëüíàÿ ïðîôèëàêòèêà, âûáðàííàÿ ñ íàèáîëåå ðàñøèðåííûì ïðîòèâîìè-

êðîáíûì äåéñòâèåì, â êðàòêèå ñðîêè ñîïóòñòâóåò ðàññàñûâàíèþ âîñïàëèòåëüíîãî ïðîöåññà è óìåíüøàåò áàêòåðèàëüíóþ

êîíòàìèíàöèþ æåë÷è.


-

-

-

-

-

òåðèàëäû ëàñòàíóûí àçàéòàäû.

Abstract

The formation of gallstones - multifactorial process that is characterized by impaired metabolism of cholesterol or bilirubin,

changes in physical and chemical properties of bile, as well as the development of the inflammatory process. According to

the composition there are 3 types of gallstones: cholesterol stones, pigment black and pigment brown stones. Cholesterol

phosphate and calcium carbonate without additives cholesterol and manifest themselves in diseases of the blood, accompanied

by chronic hemolysis, cirrhosis and other chronic liver diseases.

Analysis of preoperative data in patients in our study groups showed that the intensity of the pathological process was

characterized by clinical disease from patients with cholesterol stones. Clinical observations have been proven and justified

with analysis of laboratory tests and the results of pathological studies.

Identification of patients with brown stones opens the possibility of more individual approach to this problem. Carried

out triple antibiotic prophylaxis, selected with the most advanced anti-microbial action in the short term, is accompanied by

resorption of the inflammatory process and reduces bacterial contamination of the bile.

ïðîôèëàêòèêàñû

Prevention of pyoinflammatory complications after cholecystectomy for brown

stones in the gallbladder with destructive changes


Guseinov A.V.


– ìë.

íàó÷íûé ñîòðóäíèê îòäåëåíèÿ

õèðóðãèè ïå÷åíè ÍÖÕ èì. Òîï÷è-

áàøåâà

ò.0503672633.

-

ò.0503672633.

ABOUT THE AUTHORS:

- jr. researcher

of the Department of liver surgery

of the SCS n/a Topchibashov

ò.0503672633.


n n n

Òàáëèöà 1.

Àêòóàëüíîñòü ïðîáëåìû

Ìàòåðèàëû è ìåòîäû èññëåäîâàíèÿ


Òàáëèöà 2.

Òàáëèöà 3.

Âèäû áàêòåðèéÎñíîâíàÿ ãðóïïà

(n=25)Êîíòðîëüíàÿ ãðóïïà (n=22)

Âèä îñëîæíåíèÿ Êîíòðîëüíàÿ ãðóïïà Îñíîâíàÿ ãðóïïà

Ïîëó÷åííûå ðåçóëüòàòû


Ðèñóíîê 1.

Ðèñóíîê 2.

Ðèñóíîê 2.

± ±

±

±

±

±

±

±

±



±

±

Îáñóæäåíèå


References


Â ÑÎ×ÅÒÀÍÈÅ Ñ ÀÍÒÈÎÊÑÈÄÀÍÒÎÌ-ÀÐÃÎÑÓËÜÔÀÍÎÌ ÏÐÈ ÒÅÐÌÈ×ÅÑÊÎÌ ÎÆÎÃÅ ÊÎÆÈ

Àííîòàöèÿ

Âîçäåéñòâèå íà îñíîâíûå ïàòîãåíåòè÷åñêèå çâåíüÿ îæîãîâîé òðàâìû ñ öåëüþ âîññòàíîâëåíèÿ íîðìàëü-

íîãî ôóíêöèîíèðîâàíèÿ îðãàíèçìà êàê öå¬ëîñòíîé ñèñòåìû äî íàñòîÿùåãî âðåìåíè ÿâëÿåòñÿ òðóäíîðàç-

ðåøèìîé çàäà÷åé. Èñõîäíûå äàííûå äëÿ ðåøåíèÿ ýòîé ïðîáëåìû ôîðìèðóþòñÿ íå òîëüêî ñ ó÷åòîì îñîáåí-

íîñòåé ïàòîãåíåçà, íî è ñîãëàñíî ïàòîôèçèîëîãè÷åñêîìó îáîñíîâàíèþ, âîçìîæíîñòè è öåëåñîîáðàçíîñòè

èñïîëüçîâàíèÿ ðàçëè÷íûõ îáùèõ, ìåñòíûõ è ìàëîèíâàçèâíûõ ñðåäñòâ îäíèì èç êîòîðûõ, ÿâëÿåòñÿ íèçêî-

èíòåíñèâíîå ëàçåðíîå èçëó÷åíèå (ÍÈËÈ) è èõ êîìáèíàöèè ïðè ëå÷åíèè òåðìè÷åñêèõ îæîãîâ.

Êëþ÷åâûå ñëîâà ëàçåðíîå èçëó÷åíèå,

òåðìè÷åñêèé îæîã,

áèîñòèìóëÿöèÿ, îáðàáîòêà

ðàíû.


Abstract

The impact on the basic pathogenetic links of burn injuries in order to restore the normal functioning of the

body as an integrated system to date is a formidable task. The initial data for the solution of this problem are

formed not only on the characteristics of the pathogenesis, but also according to the pathophysiological rationale,

feasibility and advisability of the use of various general, local and minimally invasive means, one of which is a low-

intensity laser radiation (LILR), and combinations thereof in the treatment of thermal burns.

Efficiency of application low intensity laser radiation in combination with antioxidants

- argosulphan at thermal burn of skin



-

íû òàçàëàó.

Key words laser radiation, thermal burn, biostimulation, wound treatment.


-

I ÀÃÈÓÂ èì. Àëèåâà, ä.ì.í.

ABOUT THE AUTHORS:

Nazim A. Kasumov - Associate

Professor of General Surgery I

department of the ASATID n/a

Aliyev, dr.med.

–


Àêòóàëüíîñòü ïðîáëåìû Ìàòåðèàëû è ìåòîäû èññëåäîâàíèÿ


Ðèñóíîê 1.



Çàêëþ÷åíèå

±

±

±

±

±

±


References



ÌÀËÎÁÅÐÖÎÂÎÃÎ ÀÓÒÎÒÐÀÍÑÏËÀÍÒÀÒÀ

Àííîòàöèÿ

Â äàííîé ñòàòüå ïðåäñòàâëåíû ðåçóëüòàòû ìèêðîõèðóðãè÷åñêîãî ëå÷åíèÿ 25 ïàöèåíòîâ ñ îáøèðíûìè

ñåãìåíòàðíûìè äåôåêòàìè îäíîé èç êîñòåé ïðåäïëå÷üÿ, îïåðèðîâàííûõ ñ ïðèìåíåíèåì âàñêóëÿðèçèðîâàí-

íîãî ìàëîáåðöîâîãî àóòîòðàíñïëàíòàòà çà ïåðèîä ñ 2008 ïî 2015ãã. â îòäåëåíèè ðåêîíñòðóêòèâíîé, ïëàñòè-

÷åñêîé è ýñòåòè÷åñêîé ìèêðîõèðóðãèè ÍÍÖÕ èì. À.Í. Ñûçãàíîâà. Âñå îïåðàöèè âûïîëíåíû ïîä îïòè÷åñêèì

óâåëè÷åíèåì ñ ïðèìåíåíèåì ìèêðîõèðóðãè÷åñêîãî èíñòðóìåíòàðèÿ è àòðàâìàòè÷íîãî øîâíîãî ìàòåðèàëà.

Òàêèì îáðàçîì, ïðè ëå÷åíèè áîëüíûõ ñ îáøèðíûìè ñåãìåíòàðíûìè äåôåêòàìè êîñòåé ïðåäïëå÷üÿ èñïîëü-

çîâàíèå âàñêóëÿðèçèðîâàííûõ êîñòíûõ ëîñêóòîâ â êà÷åñòâå òðàíñïëàíòàòîâ-îðãàíîâ â êîñòíîïëàñòè÷åñêîé

õèðóðãèè, óëó÷øàÿ áèîìåõàíèêó ïóòåì óñêîðåíèÿ ïðîöåññîâ ïåðåñòðîéêè òðàíñïëàíòàòà, ïîçâîëÿþò çíà-

÷èòåëüíî ñîêðàòèòü ñðîêè ñîöèàëüíîé, áûòîâîé è ïðîôåññèîíàëüíîé ðåèíòåãðàöèè ïîäîáíîé êàòåãîðèè

áîëüíûõ. Çà÷àñòóþ ñâîáîäíûå êîñòíûå àóòîòðàíñïëàíòàòû íà ñîñóäèñòîé íîæêå ÿâëÿþòñÿ åäèíñòâåííûì

ñïîñîáîì âîññòàíîâëåíèÿ óòðà÷åííîé ôóíêöèè êîíå÷íîñòè.

Êëþ÷åâûå ñëîâà ïðåäïëå÷üå, òðàâìà, äåôåêòû,

ìèêðîõèðóðãèÿ.

Ìóðàäîâ Ì.È., Ñàéê Ï.Þ., Ñàäûêîâ Ò.À., Ìóõàìåäêåðèì Ê.Á., Áàéãóçåâà À.À.

-

-

Abstract

This article presents the results of microsurgical treatment of 25 patients with large segmental defects of

one of the forearm bones, operated with the use of vascularized fibular graft for the period from 2008 to 2015. in

the Department of reconstructive, plastic and aesthetic microsurgery of the NSCS named after A.N. Syzganov.

All operations were performed under optical zoom with the use of microsurgical instruments and atraumatic

suture material. Thus, in the treatment of patients with large segmental defects of the forearm bones the use of

vascularized bone grafts as transplant organs in osteoplastic surgery, improving biomechanics by accelerating

the restructuring processes of the graft, can significantly reduce the time of social, household and professional

reintegration of such patients. Often, the free bone autografts on the vascular pedicle is the only way to restore

the lost function of the extremity.

Experience of microsurgical treatment of bone defects by applying a forearm vascu-

larized fibular autograft


ôîðìàöèÿ, ìèêðîõèðóðãèÿ.

Key words forearm, trauma, defects, microsurgery.


Ìóðàäîâ Ì.È. – çàâåäóþùèé

îòäåëåíèåì, ê.ì.í., âðà÷ âûñøåé

êâàëèôèêàöèîííîé êàòåãîðèè,

e-mail: [email protected]

– ñ.í.ñ., âðà÷ - õèðóðã

ïåðâîé êâàëèôèêàöèîííîé

êàòåãîðèè.

Ñàäûêîâ Ò.À. – âðà÷ – õèðóðã,


ABOUT THE AUTHORS:

M. Muradov - head of the

department, candidate of medical

sciences, doctor of the highest

qualification category, e-mail:

[email protected]

- senior scientist, doctor

- surgeon of the first qualifying

category.

T. Sadykov – doctor - surgeon,


Ìóðàäîâ Ì.È.


– àƒà ƒûëûìè

Ñàäûêîâ Ò.À.


õèðóðã.

– õèðóðã


Àêòóàëüíîñòü.

Öåëü ðàáîòû.

Ìàòåðèàë è ìåòîäû.

Êëèíè÷åñêèé ïðèìåð.


Ðèñóíîê 1.

Ðèñóíîê 2.


Ðèñóíîê 3,4.

Ðèñóíîê 5.

Ðèñóíîê 6.

Ðèñóíîê 7.


Ðåçóëüòàòû è îáñóæäåíèå.

Çàêëþ÷åíèå.

Ðèñóíîê 8.

Ðèñóíîê 9.

Ðèñóíîê 10.




Àííîòàöèÿ

Öåëüþ èññëåäîâàíèÿ ÿâèëîñü ïðîâåäåíèå ðåòðîñïåêòèâíîãî ñðàâíèòåëüíîãî àíàëèçà îòäàëåííûõ ðåçóëüòàòîâ õè-

ðóðãè÷åñêîãî è êîíñåðâàòèâíîãî ëå÷åíèÿ áîëüíûõ ñ ÃÝÐÁ, îñëîæíåííîé ÁÝ, ïîäâåðãøèõñÿ Ëàïàðîñêîïè÷åñêîé ôóíäî-

ïëèêàöèè ïî Íèññåíó (ËÔÍ).

Ìàòåðèàëîì èññëåäîâàíèÿ ÿâèëèñü 85 ïàöèåíòîâ ñ ÃÝÐÁ, îñëîæíåííûõ, ýðîçèâíûì ýçîôàãèòîì (43) è ÁÝ (42). Èç

íèõ 42 ïàöèåíòàì ñ ÁÝ áûëà âûïîëíåíà ËÔÍ (ãðóïïà A), à îñòàëüíûõ 43 ïàöèåíòîâ ëå÷èëè êîíñåðâàòèâíî (ãðóïïà B).

Èçíà÷àëüíî âñå ïàöèåíòû ïîëó÷àëè êîíñåðâàòèâíóþ òåðàïèþ, ïî êðàéíåé ìåðå, 1 ãîä. 20 ïàöèåíòàì èç îáåèõ ãðóïï, ñ

ãëóáîêîé äèñïëàçèåé, áûëà ïðîâåäåíà ïðåäîïåðàöèîííàÿ àðãîí ïëàçìåííàÿ êîàãóëÿöèÿ (ÀÏÊ).

Ñïóñòÿ 12-24 ìåñÿöåâ ïîñëå îïåðàöèè, ïîëíàÿ ðåãðåññèÿ ìåòàïëàçèè è ñîêðàùåíèå ïëîùàäè ìåòàïëàçèè Áàððåòòà

îòìåòèòü òîò ôàêò, ÷òî áîëüøèíñòâî ïàöèåíòîâ (5 èç 7-è) â ãðóïïå A è âñå 3 áîëüíûõ èç ãðóïïû B, ó êîòîðûõ ðåãðåññèÿ

ìåòàïëàçèè è ñîêðàùåíèå ïëîùàäè ìåòàïëàçèè Áàððåòòà áûëè ïîäâåðãíóòû ÀÏÊ.

Êëþ÷åâûå ñëîâà: ÃÝÐÁ,

ïèùåâîä Áàððåòòà, ýðîçèâíûé

ýçîôàãèò, ôóíäîïëèêàöèÿ ïî

Íèññåíó.


Abstract

In this study there was carried out retrospective comparative analysis of long-term outcomes of the surgical and

conservative treatment in 85 patients with BE and EE divided into two groups, among them 60 men and 25 women.

The group A included 42 EE & BE patients who undergone Laparoscopic Nissen Fundoplication, in group B there were

43 patients who received conservative treatment. Initially, all the patients were treated conservatively for at least 1 year. The

subgroup with dysplasia was subjected to preoperative argon plasma coagulation (APC). From 1 year after surgery (group A)

and conservative treatment (group B) control biopsy specimens were obtained from the gastroesophageal junction of all the

patients.

ôóíäîïëèêàöèÿëàó

Laparoscopic nissen fundoplication in the treatment of gastroesophageal reflux dis-

ease complicated Barrett’s esophagus


Ò‰é³í ñµçäåð:

-

øà ôóíäîïëèêàöèÿëàó.

Key words: laparoscopy, Nissen fundoplication, Barrett’s esophagus.


-

âè÷ – ñò. íàó÷íûé ñîòðóäíèê

îòäåëåíèÿ õèðóðãèè ïå÷åíè ÍÖÕ

èì. Òîï÷èáàøåâà, ä.ì.í.

ò.0503103201.

ò.0503103201.

ABOUT THE AUTHORS:

- sn. of the

Department of liver surgery of the

SCS n/a Topchibashov, dr. med.

ò.0503103201.


Ââåäåíèå

Ìàòåðèàë è ìåòîäû

Ïîêàçà-

òåëè

Ãðóïïû

Íàëè÷èå ÃÏÎÄ ðàç-

íîé ñòåïåíè

Àíàìíåç áîëåçíè

áîëåå 10 ëåò

Ñòåïåíü ýçîôàãèòà

A B C D

Ãðóïïà A

Ãðóïïà B

Âñåãî

Òàáëèöà 1.


Ðåçóëüòàòû:

Ðèñóíîê 1.

Ãðóïïû

Ïîêàçàòåëè A (42) B (43) Âñåãî

Ñèìïòîìû ýçîôàãèòà

Äèñôàãèÿ

Ýíäîñêîïè÷åñêîå íàëè÷èå ýçîôàãèòà

Ýíäîñêîïè÷åñêîå íàëè÷èå ÝÝ

Ïðèíèìàþùèå ÈÏÏ

Òàáëèöà 2.


Îáñóæäåíèÿ:

B

Ìåòîäû ëå÷åíèÿ

Ñèìïòîìû

ËÔÍ

(n=22)

Ìåäèêàìåí-

òîçíîå

(n=23)

ËÔÍ + ÀÏÀ

(n=12)

Ìåäèêàìåíòîç-

íîå + ÀÏÀ (n=8)

Óìåíüøåíèå ñèìïòîìîâ

ðåôëþêñà

Ðåãðåññèÿ ìåòàïëàçèè

Èñ÷åçíîâåíèå ýçîôàãèòà

Êëèíè÷åñêîå âûçäîðîâ-

ëåíèå

Òàáëèöà 3.

Òàáëèöà 4.


Ðèñóíîê 2.


Ðèñóíîê 3.

a

c

Îñîáåííîñòè

ôèêñàöèè

Ðåçóëüòàòû

ËÔÍ áåç

ôèêñàöèè

ìàíæåòà ê

íîæêàì ýçî-

ôàãóñà

ËÔÍ ñ

ôèêñàöèèåé

ìàíæåòà ê

ïèùåâîäó

ËÔÍ ñ


ìàíæåòà ê

íîæêàì

ËÔÍ ñ


ìàíæåòà ê

íîæêàì è

ïèùåâîäó

âñåãî

Õîðîøèå è îòëè÷íûå

Óäîâëåòâîðèòåëüíûå

Òàáëèöà 4.




References


SURGICAL PATIENTS IN THE EARLY

POSTOPERATIVE PERIOD

Abstract

The article shows the dynamics of u-NGAL in patients who underwent surgery with duration of extracorporeal circulation,

pharmaco-cold (or blood) cardioplegia and hypothermia. For the purpose of comparative evaluation of all 25 patients were

duration of more than 150 min EC. The results of a comparative study of the dynamic changes set u-NGAL for 2 hours after

surgery in both groups. It turned out that patients undergoing cardiac surgery, which made surgery a lasting EC more than 150

min performance u-NGAL, some immediately and 2 hours after the operation, is relatively higher than those in patients with a

duration of less than 150 min EC.

Key words: u-NGAL, cardioplegia,

hypothermia, cardiac surgery.

Sagatov I.Ye.1,2, Abdilova G.B.1, Berdimuratova Zh.S.1.

-

Àííîòàöèÿ

Â ñòàòüå ïðåäñòàâëåíà äèíàìèêà u-NGAL ó ïàöèåíòîâ, êîòîðûì âûïîëíåíà îïåðàöèÿ â óñëîâèÿõ èñêóññòâåííîãî

êðîâîîáðàùåíèÿ, ôàðìàêîõîëîäîâîé (èëè êðîâÿíîé) êàðäèîïëåãèè è ãèïîòåðìèè. Ñ öåëüþ ñðàâíèòåëüíîé îöåíêè âñå 25

÷òî ó êàðäèîõèðóðãè÷åñêèõ ïàöèåíòîâ, êîòîðûì ïðîèçâåäåíî îïåðàòèâíîå âìåøàòåëüñòâî ñ ïðîäîëæèòåëüíîñòüþ ÈÊ áî-

ëåå 150 ìèí ïîêàçàòåëè u-NGAL, îïðåäåëåííûå ñðàçó è ÷åðåç 2 ÷àñà ïîñëå îïåðàöèè, ñðàâíèòåëüíî âûøå, ÷åì òàêîâûå

ó ïàöèåíòîâ ñ ïðîäîëæèòåëüíîñòüþ ÈÊ ìåíåå 150 ìèí.

äèíàìèêàñû

Äèíàìèêà of U-NGAL ó ïàöèåíòîâ êàðäèîõèðóðãè÷åñêîãî ïðîôèëÿ â ðàííåì

ïîñëåîïåðàöèîííîì ïåðèîäå

Ñàãàòîâ È.Å., Àáäèëîâà Ã.Á., Áåðäèìóðàòîâà Æ.Ñ.

Ò‰é³í ñµçäåðu-NGAL, êàðäèîïëåãèÿ, ãèïî-

òåðìèÿ, êàðäèîõèðóðãèÿ.

Êëþ÷åâûå ñëîâà: u-NGAL, êàðäèîïëåãèÿ, ãèïî-òåðìèÿ, êàðäèîõèðóðãèÿ.


–

âðà÷-õèðóðã îòäåëåíèÿ êàðäèîõè-

ðóðãèè ÍÍÖÕ èì.À.Í. Ñûçãàíîâà,

ä.ì.í., e-mail: inkar_sagatov@

rambler.ru;

-

åâíà – çàâåäóþùàÿ êëèíèêî-

äèàãíîñòè÷åñêîé ëàáîðàòîðèåé

ÍÍÖÕ èì. Ñûçãàíîâà, e-mail:

[email protected].

ABOUT THE AUTHORS:

Inkar Y. Sagatov –a surgeon of

cardiac surgery department of the

NSCS n/a A.N. Syzganov, dr. med.,

e-mail: [email protected];

- head of the

clinical diagnostic laboratory of

the NSCS n/a Syzganov, e-mail:

[email protected].

- À.Í.

-

ì.ƒ.ä., e-mail: inkar_sagatov@

rambler.ru;

- À.Í. Ñûçƒàíîâ

e-mail: [email protected].


Introduction

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Results and their discussion

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Fig. 1.


Conclusions

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Table 1.

References



THE ENDOVASCULAR SURGERY OF RENOVASCULAR HYPERTENSION

Abstract

From 2000 to May 2010 in Syzganov Scientific Centre of Surgery there were 33 patients in admission, who suffered from RVH and

had stenosis-occlusive lesion of other arterial base and who had other diseases.

Endovascular surgical intervention procedures were performed routinely in 33 patients with RVH. Of these, 24 were men, women -

9. Bilateral lesion in 4 patients. Repeated endovascular surgical intervention (ESI) performed in 10 cases. Patients with atherosclerotic

lesions accounted for the vast majority of the renal arteries (RA) - 23 patients with nonspecific aortoarteritis - 10 of them staged ESI

performed in 12 cases.

Single-stage endovascular surgical intervention was performed in 20 patients, 12 patients in stages. In 17 - made transluminal

balloon angioplasty (TBA) of RA on the one hand, TBA of RA bilateral - in 4 patients and TBA of brachiocephalic arteries and iliac-

femoral segment - at 11.

Thus, in the late postoperative period in patients with primary RVH stenosis and restenosis PA when we performed endovascular

the angioplasty in patients with atherosclerosis there was a significant decrease (p<0.05) of the average blood pressure: systolic 205

+ 4 mm Hg 135 + 2.2, and diastolic from 110 + 1.3 mm Hg 90+1.2 mm Hg in patients with aortoarteritis average blood pressure was

Statistical analysis of indicators of blood pressure before and after endovascular surgical treatment gave a good hemodynamic effects

in 27 patients.

Key words: multifocal stenotic lesions of

various etiologies of arterial

vessels (atherosclerosis,

aortoarteritis), endovascular

methods.

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Àííîòàöèÿ

Ñ 2000 ãîäà ïî ìàé 2010 â íàó÷íîì öåíòðå õèðóðãèè èì. Ñûçãàíîâà áûëî 33 ïàöèåíòîâ íà ïðèåìå, êîòîðûå ñòðàäàëè îò ðå-

íîâàñêóëÿðîé ãèïåðòåíçèåé (ÐÂÃ) è áûëè ñòåíîç-îêêëþçèîííûå ïîðàæåíèÿ äðóãîé àðòåðèàëüíîé áàçû è êîòîðûå èìåëè äðóãèå

çàáîëåâàíèÿ.

Ýíäîâàñêóëÿðíûå õèðóðãè÷åñêèå ïðîöåäóðû âìåøàòåëüñòâà ïðîâîäèëèñü ðåãóëÿðíî ó 33 ïàöèåíòîâ ñ ÐÂÃ. Èç íèõ 24 áûëè

ìóæ÷èíû, æåíùèí - 9. Äâóñòîðîííåå ïîðàæåíèå ó 4 ïàöèåíòîâ. Ïîâòîðíîå ýíäîâàñêóëÿðíîå õèðóðãè÷åñêîå âìåøàòåëüñòâî (ÝÕÂ)

îñóùåñòâëÿëîñü â 10 ñëó÷àÿõ. Ïàöèåíòû ñ àòåðîñêëåðîòè÷åñêèì ïîðàæåíèåì ïðèõîäèëèñü äëÿ ïîäàâëÿþùåãî áîëüøèíñòâà ïî-

÷å÷íûõ àðòåðèé (ÏÀ) - 23 ïàöèåíòîâ ñ íåñïåöèôè÷åñêèì àîðòîàðòåðèòîì - 10 èç íèõ âûïîëíåíî ñòàäèéíîå ÝÕÂ â 12 ñëó÷àÿõ.

Ó 17 - òðàíñëþìèíàëüíàÿ áàëëîííàÿ àíãèîïëàñòèêà (ÒÁÀ) ÏÀ, ñ îäíîé ñòîðîíû, ÒÁÀ ÏÀ äâóñòîðîííåãî - ó 4 áîëüíûõ è ÒÁÀ áðà-

õèîöåôàëüíûõ àðòåðèé è ïîäâçäîøíîãî áåäðåííîãî ñåãìåíòà - ó 11.

Òàêèì îáðàçîì, â îòäàëåííîì ïîñëåîïåðàöèîííîì ïåðèîäå ó áîëüíûõ ñ ïåðâè÷íûì ñòåíîçîì ÐÂÃ è ðåñòåíîçîì ÏÀ áûëè

Íè îäíîãî ñëó÷àÿ ñìåðòè â èññëåäóåìîé ãðóïïå áîëüíûõ íå íàáëþäàëîñü. Ïîñëå àíãèîïëàñòèêè ó ïàöèåíòîâ ñ àòåðîñêëåðîçîì

áûëî çíà÷èòåëüíîå óìåíüøåíèå (ð <0,05) â ñðåäíåì àðòåðèàëüíîãî äàâëåíèÿ: ñèñòîëè÷åñêîå ñ 205 + 4 ìì ðò.ñò. äî 135 + 2,2,

à äèàñòîëè÷åñêîå îò 110 + 1,3 ìì ðò.ñò. äî 90 + 1,2 ìì ðò.ñò. ó ïàöèåíòîâ ñ àîðòîàðòåðèòîì ñðåäíåå êðîâÿíîå äàâëåíèå çíà÷è-

òåëüíî óìåíüøèëîñü (ð <0,05): ñèñòîëè÷åñêîå 210 + 8,2 ìì ðò.ñò. äî 146 + 5,7 ìì ðò.ñò., è äèàñòîëè÷åñêîå îò 115 + 5,3 ìì ðò.ñò.

ëå÷åíèÿ äàë õîðîøèå ãåìîäèíàìè÷åñêèå ýôôåêòû ó 27 ïàöèåíòîâ.

Ýíäîâàñêóëÿðíàÿ õèðóðãèÿ ðåíîâàñêóëÿðíîé ãèïåðòåíçèè

Òåðãåóñ³çîâ À.Ñ., Ïàíãèðååâ Ä.Ä.

Õàí÷è Ì., Êîñïàíîâ Í.À., Îðìàíîâ Á.Ê., Äåìåóîâ Ò.Í., Àêàíîâ Å.Ê., Ìàòêåðèìîâ À.Æ., Æàêóáàåâ

Ì.À., Òåðãåóñèçîâ À.Ñ., Ïàíãèðååâ Ä.Ä.


-

ñêëåðîç, àîðòîàðòåðèò),

Êëþ÷åâûå ñëîâà: ìóëüòèôîêàëüíûå ñòåíîòè÷å-ñêèå ïîðàæåíèÿ ðàçëè÷íîé ýòè-îëîãèè àðòåðèàëüíûõ ñîñóäîâ (àòåðîñêëåðîç, àîðòîàðòåðèò), ýíäîâàñêóëÿðíûå ìåòîäû.


-

íîâè÷ - çàâåäóþùèé îòäåëåíèåì

àíãèîõèðóðãèè ÍÍÖÕ èì. Ñûçãàíîâà,

ê.ì.í., âðà÷ âûñøåé êàòåãîðèè,

õèðóðã, e-mail: Kospanov.nursultan@

gmail.com;

– âðà÷-õèðóðã îòäåëåíèÿ

àíãèîõèðóðãèè ÍÍÖÕ èì. Ñûçãàíîâà,

ê.ì.í., âðà÷ âûñøåé êàòåãîðèè,


ABOUT THE AUTHORS:

Nursultan A. Kospanov - head

of the department of angiosurgery,

can. med., a high level certificate

physician, e-mail: Kospanov.

[email protected];

Khanchi M. - surgeon of the

department of angiosurgery,

can. med., a high level certificate

physician,


- À.Í. Ñûçƒàíîâ

-

[email protected];

- À.Í. Ñûçƒàíîâ àòûí.



The aim of the study

Endovascular prosthesis, renal artery

stenting

Two-stage endovascular surgical inter-

vention

Etiological factors

RVH

number of patients Women

¹ % ¹ % ¹ %

Atherosclerosis

Aortoarteritis

Total

Table 1.


Analysis of the results endovascular surgi-

cal intervention

endovascular surgical

endovascular

surgical intervention

endovascular

surgical intervention

results of endovascular surgical intervention

endovascu-

lar surgical

endovascular surgical

intervention

Picture 1.

Picture 2.4.


References


Àííîòàöèÿ

Öåëüþ ðàáîòû ÿâèëàñü îïðåäåëèòü õàðàêòåð êîððåëÿòèâíîé ñâÿçè êëèíè÷åñêîãî òå÷åíèÿ êîìáèíèðîâàííîé èíòóáàöèîííîé

ýïèäóðàëüíîé àíåñòåçèè ñ òèïîì âåãåòàòèâíîé íåðâíîé ñèñòåìû ïðè îáøèðíûõ àáäîìèíàëüíûõ îïåðàöèÿõ.

Èññëåäîâàòåëüñêàÿ ðàáîòà ïðîâåäåíà â îòäåëåíèè Àíåñòåçèîëîãèè-ðåàíèìàöèè Íàó÷íîãî Öåíòðà Õèðóðãèè èì. àêàä.

îïåðàòèâíûì âìåøàòåëüñòâàì ïî ïîâîäó ðàçëè÷íûõ òÿæåëûõ õèðóðãè÷åñêèõ ïàòîëîãèé îðãàíîâ áðþøíîé ïîëîñòè â óñëîâèÿõ

êîìáèíèðîâàííîé èíòóáàöèîííîé ýïèäóðàëüíîé àíåñòåçèè (ÊÈÝÀ). Äëÿ îïðåäåëåíèÿ òèïà âåãåòàòèâíîé íåðâíîé ñèñòåìû (ÂÍÑ)

áûëè èñïîëüçîâàíû ïðîñòûå íåéðîôèçèîëîãè÷åñêèå òåñòû, ðàññ÷èòàíû âåãåòàòèâíûé èíäåêñ Êåðäî (ÂÈÊ) è êîýôôèöèåíò Õèë-

äåáðàíòà (ÊÕ), à òàêæå èçó÷àëèñü äàííûå ýëåêòðîýíöåôàëîãðàììà äî îïåðàöèè.

Ïî ðåçóëüòàòàì èññëåäîâàíèÿ áûëî óñòàíîâëåíî, ÷òî íà îñíîâàíèè êîìïëåêñà äàííûõ, ïîëó÷åííûõ îò ïðîñòûõ òåñòîâ, ÝÝÃ,

ÝÊÃ, ÂÈÊ, ÊÕ ìîæíî îïðåäåëèòü ïðåâîñõîäñòâî òèïà âåãåòàòèâíîé íåðâíîé ñèñòåìû. ÊÈÝÀ ìîæíî ñ÷èòàòü îïòèìàëüíûì âà-

ðèàíòîì îáùåé àíåñòåçèè, îáåñïå÷èâàþùèì íåéðîãóìîðàëüíóþ è ãåìîäèíàìè÷åñêóþ ñòàáèëüíîñòü ïðè øèðîêîìàñøòàáíûõ,

òðàâìàòè÷åñêèõ îïåðàöèÿõ íà îðãàíàõ áðþøíîé ïîëîñòè. Ó áîëüíûõ ñ ôóíêöèîíàëüíûì ðàâíîâåñèåì ñèìïàòè÷åñêîé è ïàðà-

ñèìïàòè÷åñêîé ÷àñòåé âåãåòàòèâíîé íåðâíîé ñèñòåìû, ò.å. ó íîðìàòîíèêîâ, êëèíè÷åñêîå òå÷åíèå ÊÈÝÀ õàðàêòåðèçóåòñÿ áîëåå

ñòîéêîé ãåìîäèíàìè÷åñêîé è ãóìîðàëüíîé ñòàáèëüíîñòüþ, ïî ñðàâíåíèþ ñ ñèìïàòèêî-, è ïàðàñèìïàòèêîòîíèêàìè.

Êëþ÷åâûå ñëîâà òèïû âåãåòàòèâíîé

íåðâíîé ñèñòåìû,

õèðóðãèÿ îðãàíîâ áðþøíîé

ïîëîñòè, êîìáèíèðîâàííàÿ

èíòóáàöèîííàÿ ýïèäóðàëüíàÿ

àíåñòåçèÿ.

Ãàñàíîâ Ô.Ä., Àñëàíîâ À.À., Íàìàçîâà Ê.Í., Àááàñîâà Ì.Ò., Àñêåðîâà Ã.À., Ìóñàåâà Í.Ç.,

Êåðèìîâà Õ.Ì.

-

Abstract

The aim of the study was to determine the nature of a correlation of the clinical course of combined endotracheal epidural

anesthesia with the type of the autonomic nervous system with extensive abdominal surgeries.

The research work was carried out in the Department of Anesthesiology and Resuscitation of the Scientific Center of Surgery

named after acad. M.A. Topchubashov of the Ministry of Health of Azerbaijan Republic. The objects of the study were 69 patients

who underwent surgery for a variety of serious surgical abdominal pathology in a combined endotracheal epidural anesthesia (CEEA).

To determine the type of the autonomic nervous system (ANS) there were used simple neuropsychological tests, calculated Kerdo

vegetative index (KVI) and the Hildebrand coefficient (HC), and EEG data were studied before surgery.

According to the study it was found that on the basis of complex data obtained from the simple test, EEG, ECG, KVI, HC we can

determine the type of the superiority of the autonomic nervous system. CEEA can be considered the best option of general anesthesia,

providing neurohumoral and hemodynamic stability during large-scale traumatic surgery of the abdomen. Patients with functional

balance of sympathetic and parasympathetic portions of the autonomic nervous system, i.e. normatensives, CEEA clinical course is

characterized by a persistent humoral and hemodynamic stability, compared with sympathesive- and parasympathensives.

Correlative links of clinics of combined epidural endotracheal anesthesia with type of

autonomic nervous system

Ãàñàíîâ Ô.Ä., Àñëàíîâ À.À., Íàìàçîâà Ê.Í., Àááàñîâà Ì.Ò., Àñêåðîâà Ã.À., Ìóñàåâà Í.Ç.,

Êåðèìîâà Ã.Ì.


-

àíåñòåçèÿñû

Key words types of autonomic nervous system, surgery of the abdominal cavity, combined endotracheal epidural anesthesia.

ABOUT THE AUTHORS:

- Head of the Department

of Anesthesiology and Resuscitation (DAR)

of the SCS n/a Topchubashov, a member of

the World Society of Pain, a member of the

Board of the Research Council of Scientific

Bibliographical Center USA, dr.med., e-mail:

[email protected];

Azer Aslanov - anesthesiologist-

resuscitator of DAR of the SCS n/a

Topchubashov;

Kemalya Namazova – jr. researcher of DAR

of the SCS n/a Topchubashov, cand.med.;

Mahruh Abbasova - jr. researcher of DAR

of the SCS n/a Topchubashov;

- jr. researcher of DAR of

the SCS n/a Topchubashov;

Narmina Mussayeva - jr. researcher of

DAR of the SCS n/a Topchubashov;

- anesthesiologist-

resuscitator of DAR of the SCS n/a

Topchubashov.


- Ðóêîâî-

äèòåëü îòäåëåíèÿ Àíåñòåçèîëîãèè-ðåàíè-

-

ëåíèÿ Èññëåäîâàòåëüñêîãî Ñîâåòà Íàó÷íî-

Áèáëèîãðàôè÷åñêîãî Öåíòðà ÑØÀ, ä.ì.í.,

e-mail: [email protected];

- âðà÷ àíåñòå-

-

-

- ìë.í.ñîòð.

- âðà÷


Ââåäåíèå

Öåëü èññëåäîâàíèÿ

Ìàòåðèàë è ìåòîäû.

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Ðèñóíîê 1.

Ðèñóíîê 2.


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Ðèñóíîê 3.

Òàáëèöà 1.

Òàáëèöà 2.

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Âûâîäû

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Òàáëèöà 3.



References



Êëþ÷åâûå ñëîâà öåðåáðàëüíûé èíñóëüò,

êîãíèòèâíàÿ ñôåðà, ðîíîöèò.

Ò‰é³í ñµçäåðöåðåáðàëüäû èíñóëüò,

Key wordscerebral stroke, cognitive sphere,

Ronociton.

ÏÅÐÈÎÄÅ ÖÅÐÅÁÐÀËÜÍÎÃÎ ÈÍÑÓËÜÒÀ

Àííîòàöèÿ

Ïðîáëåìà êîððåêöèè êîãíèòèâíîé ôóíêöèé ó ïàöèåíòîâ â îñòðîì ïåðèîäå öåðåáðàëüíîãî èíñóëüòà

(ÖÈ) ïðîäîëæàåò îñòàâàòüñÿ àêòóàëüíîé êàê äëÿ íåâðîëîãîâ, òàê è äëÿ ñïåöèàëèñòîâ ñìåæíûõ äèñ-

öèïëèí âñëåäñòâèå âûñîêîãî ðèñêà ôîðìèðîâàíèÿ ñîñóäèñòîé äåìåíöèè ñðåäè ïàöèåíòîâ, ïåðåíåñ-

øèõ ÖÈ. Ñíèæåíèå ïðîäîëæèòåëüíîñòè è êà÷åñòâà æèçíè äàííîé êàòåãîðèè áîëüíûõ íà ïîñëåäóþùèõ

ýòàïàõ âîññòàíîâëåíèÿ ÿâëÿåòñÿ íåìàëîâàæíûì ìåäèêî-áèîëîãè÷åñêèì è ñîöèàëüíî-ýêîíîìè÷åñêèì

àñïåêòîì âûøåóêàçàííîé ïðîáëåìû [5-7]. Öåëüþ èññëåäîâàíèÿ ÿâèëîñü èçó÷åíèå âëèÿíèÿ ïðåïàðàòà

Ðîíîöèò íà íåéðîäèíàìè÷åñêèå ïàðàìåòðû êîãíèòèâíîé ñôåðû ó áîëüíûõ â îñòðîì ïåðèîäå öåðå-

áðàëüíîãî èíñóëüòà.

Êàëêàáàåâ Æ.Ê., Íóðãîæèí Å.À., Èáðàåâà Ñ.Å., Áàéìóõàíîâ Ð.Ì., Êèñïàåâà Ò.Ò.

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-

Abstract

The problem of correction of cognitive functions in patients with the acute cerebral stroke (CS) continues

to be relevant for neurologists and specialists in related disciplines because of the high risk of the vascular

dementia formation in patients with CS. Reducing the duration and quality of life of these patients in the

later stages of recovery is important medico-biological and socio-economic aspects of the above problems

[5-7]. The aim of the study was to investigate the effect of the drug Ronociton neurodynamic parameters of

cognitive function in patients with the acute cerebral stroke.

The preventive-therapeutic correction of cognitive sphere in the acute period of

cerebral strokeABOUT THE AUTHORS:

Kalkabaev J.C. - assistent of

department, head of department of

neurorehabilitation;

Nurgozhin E.A. - director of the

Regional Medical Center;

Ibrayeva S.E. - neuropathist of

neurorehabilitation department;

Baimukhanov R.M. – docent

of neurology, neurosurgery and

oriental medicine department;

Kispaeva T.T. - acting head of

the Department of neurology,

neurosurgery and oriental

medicine, dr.med.,



- àññèñòåíò

êàôåäðû, çàâ îòäåëåíèåì íåéðî-

ðåàáèëèòàöèè;

- äèðåêòîð îá-

ëàñòíîãî ìåäèöèíñêîãî öåíòðà;

Èáðàåâà Ñ.Å. - íåâðîïàòîëîã

îòäåëåíèÿ íåéðîðåàáèëèòàöèè;

- äîöåíò

êàôåäðû íåâðîëîãèè, íåéðîõè-

ðóðãèè è âîñòî÷íîé ìåäèöèíû;

- è.î çàâåäó-

þùåãî êàôåäðû íåâðîëîãèè,

íåéðîõèðóðãèè è âîñòî÷íîé

ìåäèöèíû, ä.ì.í.


- êàôåäðà

äèðåêòîðû;

Èáðàåâà Ñ.Å. – Íåéðîðåà-áèëè-

- íåâðîëîãèÿ,

-

- íåéðîõèðóðãèÿ



Àííîòàöèÿ

Êëþ÷åâûå ñëîâà:


Âûâîäû


ªÎÆ

ò‰é³í ñµçäåð

ªäåáèåò ò³ç³ì³.

Á±ë

á³ðåãåé ìàçì±íäû

“ªä³ñ” áµë³ã³íäå

ÍÀÓ×ÍÎÃÎ ÆÓÐÍÀËÀ

àííîòàöèÿ

ÓÄÊíà àíãëèéñêîì ÿçûêå

Àííîòàöèÿ êëþ÷åâûå ñëîâà

Ñïèñîê ëèòåðàòóðû.

ïîëíûé ïåðåâîä ðóññêîãî èëè êàçàõñêîãî ñïè-

Àâòîðñêèå ðåçþìå (àííîòàöèè) äîëæíû áûòü:èíôîðìàòèâíûìè îðèãèíàëüíûìè ñîäåðæàòåëüíûìè

ñòðóêòóðèðîâàííûìè

êîìïàêòíûìè, íî íå êîðîòêèìè

Ââîäíàÿ ÷àñòü ê ñòàòüå.

Ðàçäåë “Ìåòîäèêà”

Ðàçäåë “Ðåçóëüòàòû è èõ îáñóæäåíèå”

Ðàáîòû, îôîðìëåííûå áåç ñîáëþäåíèÿ ýòèõ ïðàâèë, âîçâðà-ùàþòñÿ áåç ðàññìîòðåíèÿ.

Ðåäàêöèîííàÿ ýòèêà

OF THE “BULLETIN OF SURGERY

IN KAZAKHSTAN” SCIENTIFIC JOURNAL

Abstract, key words

References

This is one of the main requirements of the inter-complete translation

of Russian or Kazakh bibliography in English

Author abstract must be:

Introduction

“Results and discussion”

in Bulletin of surgery in Kazakhstan

Documents

¼ryr¼ r z uz · ¼ryr¼ r z uz rsr ÂÅÑÒÍÈÊ ÕÈÐÓÐÃÈÈ ÊÀÇÀÕÑÒÀÍÀ BULLETIN OF SURGERY IN KAZAKHSTAN ¹ 3 (44) 2015 Èçäàåòñÿ ñ 2005 ã. ISSN