Improving the methods of reconstructive plastic surgery, the emergence of new algorithms for managing patients, the development of pharmacology have significantly improved the results of treatment of patients with cicatricial stenosis of the larynx and cervical trachea; however, the problem continues to be relevant since the outcome of treatment is not always satisfactory. The presence of chronic respiratory failure (which often accompanies cicatricial stenosis of the respiratory tract) as well as the lack of supporting viable cartilaginous structures of the larynx and trachea aggravates the course of the disease and requires a differentiated approach to the treatment of extended cicatricial laryngotracheal stenosis. The article analyzes the effectiveness of an integrated approach to the treatment of patients with extended laryngotracheal cicatricial deformity of the lumen using allogeneic graft as well as the correction of respiratory disorders and post-hypoxic tissue changes using inhalations of a heated helium-oxygen mixture in the perioperative period. The study included 20 patients with an age interval of 20–65 years and a disease duration of 1–12 years. At the outpatient stage, the necessary clinical and radiological, endoscopic, and functional examination was carried out. To detect chronic respiratory failure, the gas and acid-base composition of the blood was studied. In the hospital, all patients underwent reconstructive plastic surgery using allogeneic graft. All patients at the pre- and postoperative stage received inhalations with a heated helium-oxygen mixture according to the developed algorithm. The study showed that an integrated approach to the treatment of patients with extended laryngotracheal cicatricial stenoses is an effective method leading to good functional results of surgical treatment, reducing the time of postoperative wound regeneration and improving the quality of life of patients.
While the world is struggling with COVID-19, the ICT industry seeks to play a constructive role in combating the spread of the virus. This book contains the abstracts of the papers presented at The First Eurasian Conference; The Coronavirus Pandemic and Critical ICT Infrastructure (PANDEMIC-ICT-2020) organized by AMIR Technical Services LLC, Tbilisi, Georgia held on November 28-30, 2020.
The objective of the present study was to analyze the complications of tracheostomy associated with bleeding from the brachiocephalic trunk. A total of 13 protocols of the autopsy study of the patients who had died in the intensive care unit were available for the analysis. These patients had experienced heavy external bleeding from the tracheostomy defect shortly before death. The study has demonstrated that all the victims had the tracheostomy hole localized below the level of the standard dissection of the tracheal rings. Nine patients presented with a damage to the brachiocephalic trunk while four others had a pressure injury to the blood vessels. The study included the elucidation of the possible relationship between the anthropometric characteristics of the patients and the variability of the passage of the brachiocephalic trunk in front of the trachea. The length of the neck was found to usually correlate with the length of the body and the brachiocephalic trunk to run in front of the trachea at the level of its 8th-11th rings. The results of the present study may be instrumental in reducing the risk of complications after tracheostomy.
В п о м о щ ь п р а к т и к у ю щ е м у в р а ч у w w w. r e a n i m a t o l o g y. c o m
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