СОВРЕМЕННЫЕ ХИРУРГИЧЕСКИЕ МЕТОДЫ ЛЕЧЕНИЯ ДИЛАТАЦИОННОЙ КАРДИОМИОПАТИИ

The high mortality and morbidity of patients in terminal heart failure are a therapeutic challenge to modern medicine. Surgically, cardiac transplantation is an excellent treatment for many patients. However, lack of donors combined with an increasing number of patients has led to the search for other surgical strategies. Although other common surgical methods’, such as Batista operation or dynamic cardiac myoplasty has a favorable outcome in selected patients, those method’s is currently not recommended for treatment of heart failure because of high surgical failure rates. The present paper reviews some of the relevant literature regarding surgical left ventricular remodeling in heart failure. Высокая заболеваемость и смертность пациентов с терминальной стадией хронической сердечной недо- статочности остается актуальной проблемой для современной медицины. Ортотопическая транспланта- ция сердца является единственным радикальным хирургическим методом лечения таких больных. Одна- ко дефицит донорских органов и возрастающее количество нуждающихся пациентов приводит к поиску новых альтернативных методов хирургического лечения. Несмотря на то что такие общеизвестные мето- дики, как операция Батисты или динамическая кардимиопластика, у некоторых пациентов имели поло- жительные результаты, на сегодняшний день из-за высокого риска осложнений и низкой эффективности выполнять их не рекомендуется. В данной статье представлен обзор современных и новых направлений в хирургическом лечении пациентов с ДКМП.

THE DYNAMICS OF THE THYROID HORMONE WHILE MODELING OF STANDARD FRACTURE IN RABBITS

The participation of Se in the structure of deiodinases during the metabolism of thyroid hormones defined the interest to the research of its possible impact to the processes of reparative regeneration of bone tissue in the experiment. The aim of the paper is to reveal the dynamics of thyroid hormone secretion at further adding of selenium under the conditions of standard fracture healing in rabbits. The most general response of the thyroid gland at the reparative regeneration of bone tissue was revealed, it is the reduction of Т, T4 and free T4 concentration during the nearest postoperative period. It is shown, that the use of the preparation of Se changes the reaction of thyroid to the dosed damage of the bone and metabolism of iodothyronines as well. The change of T3 concentration was the most evident. Rabbits having extra preparation of Se were less susceptible to fluctuations in the secretion of iodothyronines typical for the dosed damage of the bone but the syndrome of «low Т3» redoubled and peripheral conversion of thyroid hormone reduced

ACTUAL SURGICAL TREATMENT OF DILATED CARDIOMYOPATHY

The high mortality and morbidity of patients in terminal heart failure are a therapeutic challenge to modern medicine. Surgically, cardiac transplantation is an excellent treatment for many patients. However, lack of donors combined with an increasing number of patients has led to the search for other surgical strategies. Although other common surgical methods’, such as Batista operation or dynamic cardiac myoplasty has a favorable outcome in selected patients, those method’s is currently not recommended for treatment of heart failure because of high surgical failure rates. The present paper reviews some of the relevant literature regarding surgical left ventricular remodeling in heart failure

Features of the volemichesky and haemo dynamic status at patients with abdominalny sepsis

The retrospective analysis of patient's records of 54 patients with abdominalny sepsis, for the purpose of studying of features of the volemichesky status of dynamics of indicators of sokratitelny ability of a myocardium, preloading, post-loading and extra vascular water of lungs, and as for the purpose of an assessment of pro-gnostic value of these indicators is carried out. By means of technology of the modified termodilyutsiya of PiCCO plus (Pulsiоn Medical Systems», Germany) carried out monitoring of haemo dynamics and the volemichesky status. At implementation of the analysis of measurements, such as the index of extra vascular water of lungs (IEVWL), an index of intra chest volume of blood (IICVB), an index of global final and diastolic volume (IGFDV), an index of function of heart (IFS), an index of system vascular resistance (ISSS), established that negative dynamics of indicators of sokratitelny ability of a myocardium and IEVWL are failure prediktor at patients with abdominalny sepsis