СРАВНЕНИЕ ТРЕХ СПОСОБОВ ЛЕЧЕНИЯ ПЕРЕЛОМОВ ПЯТОЧНОЙ КОСТИ

Until now the problem of selecting a conservative or operative treatment option for calcaneal fractures and moreover the choice of the most optimal surgical procedure for such lesions have not been solved. Thus, comparative studies in this area is one of the most important tasks of the modern traumatology. Purpose of the study — to compare treatment outcomes, pattern and complications rate following the use of three treatment options for calcaneal fractures. Material and Methods. The authors analyzed treatment outcomes of 95 patients from 2013 till 2016. Mean age of patients was 39.04±12.51 years. Patients were divided into three groups: group 1 consisted of 41 patients with 54 fractures who underwent functional conservative treatment; group 2 consisted of 18 patients with 22 fractures treated by open reduction and plate fixation; group 3 consisted of 36 patients with 40 fractures treated by minimally invasive reduction and intramedullary fixation. Groups did not differ in respect of risk factors rate and rate of surgical risks under ABCDEF scale. Outcomes were evaluated basing on roentgenological criteria of reduction, complications rate and the functional scales FFI (Foot Function Index) and LEFS (Lower Extremity Functional Score). Results. Mean follow up was 20.8±9.0 months. Catamnesis was controlled in 68 out of 95 patients (71.6%). Variances were observed for all criteria of reduction quality between group 1 (no reduction) and groups 2 and 3. Groups 2 and 3 demonstrated similar criteria in respect of reduction quality of posterior articular surface, restoration of height and axis of calcaneus (р0.05). FFI and LEFS scores in group 1 were inferior to results in groups 2 and 3 (р0.05) at 6 and 12 months follow up. At 24 months follow up the variances persisted for mean values but were not statistically significant (р0.05). No differences between groups 2 and 3 were observed during all follow up terms (р0.05). Sum rate of complications in wound healing in group 2 was significantly higher than in groups 1 and 3 (р = 0.033). Conclusion. Any of the described options of surgical treatment resulted in an earlier functional restoration after calcaneal fractures as compared to conservative treatment. Reduction quality and late functional outcomes did not vary between the study groups, however, the rate of complications for wound healing in the group with open internal fixation was higher.Актуальность. Вопросы выбора консервативного или оперативного лечения при переломах пяточной кости, а тем более выбора оптимального метода хирургического лечения этих переломов, окончательно не решены. Проведение сравнительных исследований в этой области является одной из важных задач современ-ной травматологии. Цель исследования — сравнить функциональные результаты, характер и частоту осложнений при примене-нии трех способов лечения переломов пяточной кости. Материал и методы. Представлены результаты лечения 95 пациентов, проходивших лечение с 2013 по 2016 г. Средний возраст пациентов составил 39,04±12,51 лет. Пациентов разделили на три группы: группу 1 составил­ 41 пациент с 54 переломами после функционального консервативного лечения; группу 2 — 18 паци-ентов с 22 переломами после открытой репозиции и накостного остеосинтеза; группу 3 — 36 пациентов с 40 переломами после миниинвазивной репозиции и остеосинтеза штифтом. Группы не отличались по частоте встречаемости факторов риска неблагоприятных исходов и степени хирургического риска по шкале ABCDEF. Оценку результатов производили на основании рентгенологических критериев репозиции, частоты осложне-ний и показателей функциональных шкал FFI (Foot Function Index) и LEFS (Lower Extremity Functional Score). Результаты. Средний срок наблюдения составил 20,8±9,0 мес. Катамнез отслежен у 68 пациентов из 95 (71,6%). Разницу по всем показателям качества репозиции наблюдали между группой 1, где репозиция не проводилась, и группами 2 и 3 (р0,05). Группы 2 и 3 были одинаковы по качеству репозиции задней сус­ тавной площадки, восстановлению высоты и оси пяточной кости (р0,05). Показатели FFI и LEFS в группе 1 уступали показателям в группах 2 и 3 (р0,05) на сроках 6 и 12 мес. На сроке в 24 мес. различия сохранялись в средних значениях, но не были статистически значимыми (р0,05). Различий между группами 2 и 3 не вы-явлено на всех сроках наблюдения (р0,05). Суммарная частота осложнений заживления раны в группе 2 была значимо выше, чем в группах 1 и 3 (р = 0,033). Выводы. Каждый из представленных видов оперативного лечения по сравнению с консервативным по-зволяет быстрее восстановить функцию после перелома пяточной кости. Применение минимально инвазив-ной репозиции и остеосинтеза штифтом не уступает по функциональным результатам открытой репозиции и накостной фиксации, но несет меньший риск осложнений при заживлении раны

In-situ heavy oil aquathermolysis in the presence of nanodispersed catalysts based on transition metals

The aquathermolysis process is widely considered to be one of the most promising approaches of in-situ upgrading of heavy oil. It is well known that introduction of metal ions speeds up the aquathermolysis reactions. There are several types of catalysts such as dispersed (heterogeneous), water-soluble and oil soluble catalysts, among which oil-soluble catalysts are attracting considerable interest in terms of efficiency and industrial scale implementation. However, the rock minerals of reservoir rocks behave like catalysts; their influence is small in contrast to the introduced metal ions. It is believed that catalytic aquathermolysis process initiates with the destruction of C-S bonds, which are very heat-sensitive and behave like a trigger for the following reactions such as ring opening, hydrogenation, reforming, water–gas shift and desulfurization reactions. Hence, the asphaltenes are hydrocracked and the viscosity of heavy oil is reduced significantly. Application of different hydrogen donors in combination with catalysts (catalytic complexes) provides a synergetic effect on viscosity reduction. The use of catalytic complexes in pilot and field tests showed the heavy oil viscosity reduction, increase in the content of light hydrocarbons and decrease in heavy fractions, as well as sulfur content. Hence, the catalytic aquathermolysis process as a distinct process can be applied as a successful method to enhance oil recovery. The objective of this study is to review all previously published lab scale and pilot experimental data, various reaction schemes and field observations on the in-situ catalytic aquathermolysis process

Catalytic aquathermolysis of boca de jaruco heavy oil with nickel-based oil-soluble catalyst

© 2020 by the authors. This paper investigates aquathermolysis of heavy oil in carbonate reservoir rocks from Boca de Jaruco, which is developed by the cyclic steam stimulation method. The nickel-based catalyst precursor was introduced in order to intensify the conversion processes of heavy oil components. The active form of such catalysts-nickel sulfides-are achieved after steam treatment of crude oil at reservoir conditions. The experiments were carried out on a rock sample extracted from the depth of 1900 m. Changes in composition and structure of heavy oil after the conversion were identified using SARA-analysis, Gas Chromatography-Mass Spectroscopy of saturated fractions, FTIR spectroscopy of saturated fractions, and MALDI of resins. It is revealed that catalyst particles provide a reduction in the content of resins and asphaltenes due to the destruction of carbon-heteroatom bonds. Moreover, the destruction of C=Carom. bonds and interactions with aromatic rings are heightened. In contrast, the results of experiments in the absence of catalysts exposed polymerization and condensation of aromatic rings. The most remarkable result to emerge from the thermo-catalytic influence is the irreversible viscosity reduction of produced crude oil enhancing the oil recovery factor. Moreover, the introduction of catalysts increases the gas factor due to additional gas generation as a result of aquathermolysis reactions. The yield of methane gas is significantly high in the experimental runs with oil-saturated rocks rather than crude oil experiments. The gas factor reaches 45 m3/ton