Авторы: доктор медицинских наук, профессор В.Ф. Беженарь академик РАН, доктор медицинских наук, профессор Э.К. Айламазян доктор медицинских наук, профессор И.Е. Зазерская доктор медицинских наук, профессор Д.О. Иванов доктор медицинских наук, профессор Б.В. Аракелян доктор медицинских наук, доцент А.Е. Баутин ассистент О.А. Беттихер кандидат медицинских наук Г.В. Гриненко кандидат медицинских наук Ю.В. Долго-Сабурова кандидат медицинских наук К.А. Загородникова доктор медицинских наук, профессор М.С. Зайнулина кандидат медицинских наук, доцент А.Б. Ильин кандидат медицинских наук М.Ф. Ипполитова кандидат медицинских наук, доцент А.Н. Кучерявенко доктор медицинских наук, профессор В.А. Мазурок кандидат медицинских наук И.М. Нестеров доктор медицинских наук, профессор В.А. Шапкайц Рецензенты: Дмитрий Анатольевич Лиознов-доктор медицинских наук, профессор, исполняющий обязанности директора ФГБУ «Научно-исследовательский институт гриппа им. А.А. Сморо динцева» Министерства здравоохранения РФ; заведующий кафедрой инфекционных болезней и эпидемиологии ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Министерства здравоохранения Российской Федерации Алексей Валерьянович Щеголев-доктор медицинских наук, профессор, полковник медицинской службы, начальник кафедры военной анестезиологии и реаниматологии ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской Федерации, главный анестезиолог-реаниматолог Министерства обороны Российской Федерации Николай Николаевич Рухляда-доктор медицинских наук, профессор заведующий кафедрой акушерства и гинекологии ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской Федерации Андрей Александрович Шмидт-кандидат медицинских наук, доцент, полковник медицинской службы, начальник кафедры акушерства и гинекологии ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской Федерации, главный акушергинеколог Министерства обороны Российской Федерации К49 Краткие клинические рекомендации. Тактика ведения беременных, рожениц и родильниц с подозрением или подтвержденной инфекцией COVID-19.
Aim. To compare the results of surgical treatment using bipolar hemostasis and traditional ligation of ligaments and blood vessels in vaginal hysterectomy.Material and methods. Fifty patients with benign uterine disease underwent vaginal hysterectomy using electrosurgery (n = 29) or conventional suture ligation (n = 21 controls).Results. Postoperative pain (especially on the fi rst day) was decreased in the electrosurgery group (5.50 ± 1.43 VAS points) as compared to the control group (7.64 ± 0.58 points), p < 0.001. Intraoperative blood loss was signifi cantly lower in electrosurgery group (82.86 ± 22.58 ml) than in the control group (226.36 ± 129.12 ml), p < 0.001. Operating time was signifi cantly shorter in the main group than in the controls (65.36 ± 20.9 min vs. 86.59 ± 40.19 min, p < 0.05). On average, 2.75 ± 1.11 suture packages were used with bipolar coagulation, 6.00 ± 1.93 in the controls (p < 0.001). Hospital stay was similar for both groups. Adverse event rates did not differ signifi cantly.Conclusions. Bipolar coagulation with the TissueSeal Plus proved to be more effi cient or identical to traditional suture ligation. Intraoperative blood loss, postoperative pain and the duration of the operation were less, while the complications were identical for both groups. In addition, bipolar coagulation was easier to use and cost effective. These fi ndings prove the feasibility and effectiveness of the use of electrosurgical techniques to perform hysterectomy and its further study
The aim of this research was to analyze the results of the experience of 85 laparoscopic myomectomy, performed by standardized surgical technique in the Department of Operative Gynecology of Ott Institute of Obstetrics and Gynecology. Developed and describes the main stages of the operation. Analysis of intra- and postoperative complications, duration of hospitalization demonstrated effectiveness and safety of this surgical technique. The most important task of this technique — the formation of a wealthy uterine scar
Introduction. The technique of visualization, the definition of «anomalies» of the uterine scar differ in all of publications devoted to the study of morphological changes of the uterine scar after cesarean section (CS) in non-pregnant women. The aim of our study was to determine the optimal algorithm for the diagnosis of uterine scar local thinning. Materials and methods. The ultrasound examination of pelvic organs was performed for thepatients not less than 6 months after CS. 40 women had scar thinning creating the shape of «niche». Next there was performedthe MRI study. One patient had ultrasound the contrast examination with the intrauterine introduction of the physiological solution and for the other one we performed the contrast examination with microbubble preparation of the sulfur hexafluoride. All the patients with the«niche» detectedunderwent the hysteroscopy. Results. The ultrasound examination revealed that the residual thickness of the myometrium of the uterine scar was 3,3±1,54 mm. The sensitivity of the method was 63% and specificity was 62%. The MRI revealed the residual thickness of the myometrium 3,44±1,64 mm. The sensitivity of the method was 80% and the specificity was 71% (p<0,05). During the hysteroscopy the «niche» was visualized in 95% of cases. Conclusion. To reduce the measurement error and to detect the necessity of surgical treatment there is necessary to apply at least two different studies (routine ultrasound, ultrasound with contrast agent and MRI). In the severe cases there is important to use hysteroscopy as the additional technique, which allows to visualize the defect accurately.
THE AIM: To assess the significance of prognostic markers of preeclampsia – sFlt-1 and PlGF in the differential diagnosis of preeclampsia and chronic kidney disease.PATIENTS AND METHODS:patients whom signed informed consent, was taken samples of blood in the third trimester of pregnancy. The study group included 36 patients with preeclampsia, the comparison group of 46 pregnant women with CKD and the control group included 40 healthy patients, with pregnancy without complication.RESULTS: Significant differences in the levels of serum sFlt-1 and PlGF were found: between the PE and the comparison group (CKD), as well as between the PE and the control group (CG), whereas no differences were found between the CG and CKD. The sFlt-1 level was significantly increased in PE compared with CKD and KG (5.12-fold and 4.25-fold higher, respectively). Serum PlGF levels were significantly reduced in PE relative to both CKD and KG (17.4 and 12.5 times lower, respectively). The sFlt-1/PlGF ratio was significantly increased in PE compared with CKD and the control group (approximately 25 times higher in both groups), but there was no significant difference between CKD and CG.CONCLUSION:Thus, the definition of the relationship sFlt-1, PlGF, sFlt-1/PlGF can be used in the differential diagnosis of preeclampsia and chronic kidney disease.
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