44 research outputs found

    Finite-difference iterative solver with spectrally equivalent preconditioner for anisotropic electrical impedance tomography problems

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    сСкция: Π”ΠΈΡ„Ρ„Π΅Ρ€Π΅Π½Ρ†ΠΈΠ°Π»ΡŒΠ½Ρ‹Π΅ уравнСния ΠΈ ΠΈΡ… ΠΏΡ€ΠΈΠ»ΠΎΠΆΠ΅Π½ΠΈ

    Investigation of the properties of magnetocaloric Mn1-xFexNiGe (0.05 ≀ x ≀ 0.30) films

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    MnNiGe-based solid solutions are currently positioned as β€œgreen” magnetocaloric materials, promising for use in magnetic refrigerators [1-3]. The magnetic behavior of the MnNiGe system is strongly dependent on doping, special heat treatment, pressure imposition, etc. One of the most important factors determining the magnetic behavior of the system is the state of the sample - film or massive. Π’Π²Π΅Ρ€Π΄Ρ‹Π΅ растворы Π½Π° основС MnNiGe Π² настоящСС врСмя ΠΏΠΎΠ·ΠΈΡ†ΠΈΠΎΠ½ΠΈΡ€ΡƒΡŽΡ‚ΡΡ ΠΊΠ°ΠΊ Β«Π·Π΅Π»Π΅Π½Ρ‹Π΅Β» магнитокалоричСскиС ΠΌΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹, пСрспСктивныС для использования Π² ΠΌΠ°Π³Π½ΠΈΡ‚Π½Ρ‹Ρ… Ρ…ΠΎΠ»ΠΎΠ΄ΠΈΠ»ΡŒΠ½ΠΈΠΊΠ°Ρ… [1-3]. ΠœΠ°Π³Π½ΠΈΡ‚Π½ΠΎΠ΅ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ систСмы MnNiGe сильно зависит ΠΎΡ‚ лСгирования, ΡΠΏΠ΅Ρ†ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ€ΠΌΠΎΠΎΠ±Ρ€Π°Π±ΠΎΡ‚ΠΊΠΈ, давлСния ΠΈ Ρ‚. Π”. Одним ΠΈΠ· Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²Π°ΠΆΠ½Ρ‹Ρ… Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ², ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΡΡŽΡ‰ΠΈΡ… ΠΌΠ°Π³Π½ΠΈΡ‚Π½ΠΎΠ΅ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ систСмы, являСтся состояниС ΠΎΠ±Ρ€Π°Π·Ρ†Π° - ΠΏΠ»Π΅Π½ΠΊΠΈ ΠΈΠ»ΠΈ массива

    БочСтанная анСстСзия ΠΏΡ€ΠΈ ΠΊΠΎΡ€ΠΎΠ½Π°Ρ€Π½ΠΎΠΌ ΡˆΡƒΠ½Ρ‚ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠΈ Π±Π΅Π· искусствСнного кровообращСния Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π²ΠΈΡΡ†Π΅Ρ€Π°Π»ΡŒΠ½Ρ‹ΠΌ ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ΠΌ

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    The objective: to analyze results of the use of combined anesthesia for coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG) in patients with visceral obesity (VO). Subjects and methods. A randomized study of results of surgical treatment in patients with VO and coronary heart disease who underwent off-pump CABG was conducted. 197 patients were included in the study. The main group (n = 98) included patients who underwent combined anesthesia (with thoracic epidural analgesia (TEA)) and patients in the control group (n = 99) underwent total intravenous anesthesia (with narcotic analgesics). Results. In patients from the main group, a significant decrease in the incidence of acute kidney injury (p = 0.0180), respiratory complications (p = 0.0177), atrial and ventricular arrhythmias (p = 0.0029) was recorded. With the use of TEA, the duration of treatment of patients in the intensive care unit (p = 0.0229) and duration of hospital stay (p = 0.0419) significantly decreased. Conclusion: The use of combined anesthesia (with TEA) for off-pump CABG in patients with visceral obesity reduces the risk of early postoperative complications, the duration of hospital stay and treatment in the intensive care unit.ЦСль: провСсти Π°Π½Π°Π»ΠΈΠ· Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² примСнСния сочСтанной анСстСзии ΠΏΡ€ΠΈ ΠΊΠΎΡ€ΠΎΠ½Π°Ρ€Π½ΠΎΠΌ ΡˆΡƒΠ½Ρ‚ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠΈ Π±Π΅Π· искусствСнного кровообращСния (off-pump КШ) Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π²ΠΈΡΡ†Π΅Ρ€Π°Π»ΡŒΠ½Ρ‹ΠΌ ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ΠΌ (Π’Πž). ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Ρ€Π°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ΅ исслСдованиС Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² хирургичСского лСчСния Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ΠΈΡˆΠ΅ΠΌΠΈΡ‡Π΅ΡΠΊΠΎΠΉ болСзнью сСрдца с Π’Πž, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΌ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΎ off-pump КШ. Π’ исслСдованиС Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΎ 197 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². ΠžΡΠ½ΠΎΠ²Π½ΡƒΡŽ Π³Ρ€ΡƒΠΏΠΏΡƒ (n = 98) составили ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹, Ρƒ ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… выполняли ΡΠΎΡ‡Π΅Ρ‚Π°Π½Π½ΡƒΡŽ Π°Π½Π΅ΡΡ‚Π΅Π·ΠΈΡŽ (с Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ ΡΠΏΠΈΠ΄ΡƒΡ€Π°Π»ΡŒΠ½ΠΎΠΉ анальгСзиСй β€’ ГЭА), Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½ΠΎΠΉ Π³Ρ€ΡƒΠΏΠΏΡ‹ (n = 99) ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Ρ‚ΠΎΡ‚Π°Π»ΡŒΠ½ΡƒΡŽ Π²Π½ΡƒΡ‚Ρ€ΠΈΠ²Π΅Π½Π½ΡƒΡŽ Π°Π½Π΅ΡΡ‚Π΅Π·ΠΈΡŽ (с наркотичСскими Π°Π½Π°Π»ΡŒΠ³Π΅Ρ‚ΠΈΠΊΠ°ΠΌΠΈ). Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π£ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² основной Π³Ρ€ΡƒΠΏΠΏΡ‹ зафиксировано статистичСски Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ сниТСниС частоты развития острого поврСТдСния ΠΏΠΎΡ‡Π΅ΠΊ (p = 0,0180), рСспираторных ослоТнСний (p = 0,0177), прСдсСрдных ΠΈ ΠΆΠ΅Π»ΡƒΠ΄ΠΎΡ‡ΠΊΠΎΠ²Ρ‹Ρ… Π°Ρ€ΠΈΡ‚ΠΌΠΈΠΉ (p = 0,0029). На Ρ„ΠΎΠ½Π΅ примСнСния ГЭА статистичСски Π·Π½Π°Ρ‡ΠΈΠΌΠΎ снизилась Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ лСчСния Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π² ΠΏΠ°Π»Π°Ρ‚Π΅ интСнсивной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ (p = 0,0229) ΠΈ послСопСрационной госпитализации (p = 0,0419). Π’Ρ‹Π²ΠΎΠ΄. ΠŸΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ сочСтанной анСстСзии (с ГЭА) ΠΏΡ€ΠΈ off-pump КШ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π’Πž позволяСт ΡΠ½ΠΈΠ·ΠΈΡ‚ΡŒ риск развития Ρ€Π°Π½Π½ΠΈΡ… послСопСрационных ослоТнСний, Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ послСопСрационной госпитализации ΠΈ ΠΏΡ€ΠΎΠ΄ΠΎΠ»ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ лСчСния Π² ΠΏΠ°Π»Π°Ρ‚Π΅ интСнсивной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ

    The morphology and surface wettability alloy AMg2M modified precipitation of Mo under ion assistance

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    Π˜Π·ΡƒΡ‡Π΅Π½Ρ‹ закономСрности смачивания повСрхности алюминиСвого сплава АМг2М послС осаТдСния Мо ΠΏΡ€ΠΈ ΠΈΠΎΠ½Π½ΠΎΠΌ ассистировании, ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ΅ сниТаСт ΡˆΠ΅Ρ€ΠΎΡ…ΠΎΠ²Π°Ρ‚ΠΎΡΡ‚ΡŒ повСрхности. УстановлСно, Ρ‡Ρ‚ΠΎ ΠΏΠΎΠ²Π΅Ρ€Ρ…Π½ΠΎΡΡ‚ΡŒ сплава становится Π³ΠΈΠ΄Ρ€ΠΎΡ„ΠΎΠ±Π½ΠΎΠΉ ΠΏΡ€ΠΈ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠΈ ΡƒΡΠΊΠΎΡ€ΡΡŽΡ‰Π΅Π³ΠΎ напряТСния для Π°ΡΡΠΈΡΡ‚ΠΈΡ€ΡƒΡŽΡ‰ΠΈΡ… ΠΈΠΎΠ½ΠΎΠ² Мо+ Π΄ΠΎ Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΉ 9, 12, 15 ΠΊΠ’, Π° исходная ΠΏΠΎΠ²Π΅Ρ€Ρ…Π½ΠΎΡΡ‚ΡŒ Π΄ΠΎ модифицирования Π±Ρ‹Π»Π° Π³ΠΈΠ΄Ρ€ΠΎΡ„ΠΈΠ»ΡŒΠ½ΠΎΠΉ.The paper discusses the wetting regularities of the aluminum alloy AMg2M surface after modification by deposition of Mo with ion assisting, which reduces the surface roughness. It is established that the alloy surface becomes hydrophobic for accelerating voltage above 9 kV, while the surface before modification was hydrophilic

    Topography of the surface of precursors Cu-Zn-Sn layered electrochemically deposited on Mo / glass and Mo-foil

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    РассмотрСна Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ΡŒ построСния Ρ‚ΠΎΠ½ΠΊΠΎΠΏΠ»Π΅Π½ΠΎΡ‡Π½Ρ‹Ρ… Ρ„ΠΎΡ‚ΠΎΠΏΡ€Π΅ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Ρ‚Π΅Π»Π΅ΠΉ Π½Π° основС нСтоксичных ΠΈ доступных ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ‚ΠΎΠ² Cu2ZnSnSe4 Π½Π° ΠΏΠΎΠ΄Π»ΠΎΠΆΠΊΠ°Ρ… ΠΈΠ· стСкла ΠΈ Π³ΠΈΠ±ΠΊΠΎΠΉ мСталличСской Ρ„ΠΎΠ»ΡŒΠ³ΠΈ, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ ΠΎΡ‚ΠΊΡ€Ρ‹Π²Π°ΡŽΡ‚ возмоТности примСнСния Π³ΠΈΠ±ΠΊΠΈΡ… Ρ‚ΠΎΠ½ΠΊΠΎΠΏΠ»Π΅Π½ΠΎΡ‡Π½Ρ‹Ρ… Ρ„ΠΎΡ‚ΠΎΠΏΡ€Π΅ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Ρ‚Π΅Π»Π΅ΠΉ. ΠŸΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Π΅ структуры исслСдованы ΠΌΠ΅Ρ‚ΠΎΠ΄Π°ΠΌΠΈΠ°Ρ‚ΠΎΠΌΠ½ΠΎ-силовой ΠΈ ΡΠΊΠ°Π½ΠΈΡ€ΡƒΡŽΡ‰Π΅ΠΉ элСктронной микроскопии.We discuss the abibility to construct thin-film solar cells based on non-toxic and available Cu2ZnSnSe4 components on glass substrates and flexible metal foil, which opens the possibility of application of flexible solar cells. The structures were studied by atomic force and scanning electron microscopy combined with energy dispersive spectrometry of secondary electrons

    Influence of the substrate type on the surface morphology of Cu2ZnSnSe4 thin films

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    Investigations into the influence of the substrate type (a glass substrate with a molybdenum sublayer, tantalum and molybdenum foils) on the surface morphology of Cu2ZnSnSe4 thin films obtained by selenization of electrochemically deposited and preliminary annealed metallic precursors are presented. ИсслСдования влияния Ρ‚ΠΈΠΏΠ° ΠΏΠΎΠ΄Π»ΠΎΠΆΠΊΠΈ (стСклянная ΠΏΠΎΠ΄Π»ΠΎΠΆΠΊΠ° с подслоСм ΠΌΠΎΠ»ΠΈΠ±Π΄Π΅Π½Π°, Ρ„ΠΎΠ»ΡŒΠ³ΠΈ Ρ‚Π°Π½Ρ‚Π°Π»Π° ΠΈ ΠΌΠΎΠ»ΠΈΠ±Π΄Π΅Π½Π°) Π½Π° ΠΌΠΎΡ€Ρ„ΠΎΠ»ΠΎΠ³ΠΈΡŽ повСрхности Ρ‚ΠΎΠ½ΠΊΠΈΡ… ΠΏΠ»Π΅Π½ΠΎΠΊ Cu2ZnSnSe4, ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Ρ… ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Π° сСлСнизация элСктрохимичСски осаТдСнных ΠΈ ΠΏΡ€Π΅Π΄Π²Π°Ρ€ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ ΠΎΡ‚ΠΎΠΆΠΆΠ΅Π½Π½Ρ‹Ρ… мСталличСских прСкурсоров

    Equivalence of Conventionally-Derived and Parthenote-Derived Human Embryonic Stem Cells

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    As human embryonic stem cell (hESC) lines can be derived via multiple means, it is important to determine particular characteristics of individual lines that may dictate the applications to which they are best suited. The objective of this work was to determine points of equivalence and differences between conventionally-derived hESC and parthenote-derived hESC lines (phESC) in the undifferentiated state and during neural differentiation.hESC and phESC were exposed to the same expansion conditions and subsequent neural and retinal pigmented epithelium (RPE) differentiation protocols. Growth rates and gross morphology were recorded during expansion. RTPCR for developmentally relevant genes and global DNA methylation profiling were used to compare gene expression and epigenetic characteristics. Parthenote lines proliferated more slowly than conventional hESC lines and yielded lower quantities of less mature differentiated cells in a neural progenitor cell (NPC) differentiation protocol. However, the cell lines performed similarly in a RPE differentiation protocol. The DNA methylation analysis showed similar general profiles, but the two cell types differed in methylation of imprinted genes. There were no major differences in gene expression between the lines before differentiation, but when differentiated into NPCs, the two cell types differed in expression of extracellular matrix (ECM) genes.These data show that hESC and phESC are similar in the undifferentiated state, and both cell types are capable of differentiation along neural lineages. The differences between the cell types, in proliferation and extent of differentiation, may be linked, in part, to the observed differences in ECM synthesis and methylation of imprinted genes

    ΠŸΡ€ΠΎΠ³Π½ΠΎΡΡ‚ΠΈΡ‡Π΅ΡΠΊΠ°Ρ модСль риска развития энцСфалопатии Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π°Π»ΠΈΠΌΠ΅Π½Ρ‚Π°Ρ€Π½Ρ‹ΠΌ ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·ΠΎΠΌ

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    The objective: to develop a predictive model for assessing the risk of developing encephalopathy (EP) in patients with nutritional pancreatic necrosis.Subjects and Methods. A single-center prospective cohort study was conducted at Faculty Surgery Clinic of Volgograd State Medical University from 2010 to 2020. Logistic regression analysis was used to build a model for predicting the risk of developing EP.Results. A total of 429 patients were included in the study. It was determined that in the majority of patients EP manifested in the first three days after hospitalization. A statistically significant predictive model of correlation of the risk to develop EP with clinical and demographic variables showed that an increase in the severity of the patient's condition (according to the SOFA scale) by 1 point increased the risk by 1.9 times, and an increase in bilirubin levels by 1 ΞΌmol/l, and urea by 1 mmol/l increased the risk of AED by 8.0% and 28.0%, respectively. In non-alcoholic pancreatic necrosis, compared with the alcoholic genesis of the disease, and when using early (before day 3) enteral nutrition, there was a significant reduction in the risk of developing EP by 175.5% and 137% of cases. The specificity and sensitivity of the model were 78.7% and 82.8%, respectively.Conclusions. In nurtitional pancreatic necrosis, an increase in the severity of the patient's condition, alcoholic genesis of the disease, progression of signs of liver and kidney failure significantly increased the risk of developing EP. At the same time, early enteral nutrition contributed to a significant reduction in the risk of this complication. The presented predictive model is recommended to be used in routine clinical practice.  ЦСль: Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚Π°Ρ‚ΡŒ ΠΏΡ€ΠΎΠ³Π½ΠΎΡΡ‚ΠΈΡ‡Π΅ΡΠΊΡƒΡŽ модСль ΠΎΡ†Π΅Π½ΠΊΠΈ риска развития энцСфалопатии (ЭП) Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π°Π»ΠΈΠΌΠ΅Π½Ρ‚Π°Ρ€Π½Ρ‹ΠΌ ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·ΠΎΠΌ.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΎΠ΄Π½ΠΎΡ†Π΅Π½Ρ‚Ρ€ΠΎΠ²ΠΎΠ΅ проспСктивноС ΠΊΠΎΠ³ΠΎΡ€Ρ‚Π½ΠΎΠ΅ исслСдованиС Π½Π° Π±Π°Π·Π΅ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΈ Ρ„Π°ΠΊΡƒΠ»ΡŒΡ‚Π΅Ρ‚ΡΠΊΠΎΠΉ Ρ…ΠΈΡ€ΡƒΡ€Π³ΠΈΠΈ Π’ΠΎΠ»Π³Π“ΠœΠ£ Π·Π° ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ с 2010 ΠΏΠΎ 2020 Π³. Для построСния ΠΌΠΎΠ΄Π΅Π»ΠΈ прогнозирования риска развития панкрСатичСской ЭП использовали логистичСский рСгрСссионный Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ВсСго Π² исслСдованиС Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΎ 429 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². ΠžΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΎ, Ρ‡Ρ‚ΠΎ Ρƒ Π±ΠΎΠ»ΡŒΡˆΠΈΠ½ΡΡ‚Π²Π° Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ЭП манифСстировала Π² 1-Π΅, 2-Π΅ ΠΈΠ»ΠΈ 3-ΠΈ сут послС госпитализации. БтатистичСски значимая прогностичСская модСль зависимости риска развития ЭП ΠΎΡ‚ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-дСмографичСских ΠΏΠ΅Ρ€Π΅ΠΌΠ΅Π½Π½Ρ‹Ρ… ΠΏΠΎΠΊΠ°Π·Π°Π»Π°, Ρ‡Ρ‚ΠΎ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ тяТСсти состояния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² (ΠΏΠΎ шкалС SOFA) Π½Π° 1 Π±Π°Π»Π» ΠΏΠΎΠ²Ρ‹ΡˆΠ°Π»ΠΎ риск Π² 1,9 Ρ€Π°Π·Π°, Π° ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ ΡƒΡ€ΠΎΠ²Π½Π΅ΠΉ Π±ΠΈΠ»ΠΈΡ€ΡƒΠ±ΠΈΠ½Π° Π½Π° 1 мкмоль/Π» ΠΈ ΠΌΠΎΡ‡Π΅Π²ΠΈΠ½Ρ‹ Π½Π° 1 ммоль/Π» ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΠ²Π°Π»ΠΎ риск ЭП Π½Π° 8 ΠΈ 28% соотвСтствСнно. ΠŸΡ€ΠΈ нСалкогольном ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·Π΅, ΠΏΠΎ ΡΡ€Π°Π²Π½Π΅Π½ΠΈΡŽ с Π°Π»ΠΊΠΎΠ³ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ Π³Π΅Π½Π΅Π·ΠΎΠΌ заболСвания, ΠΈ ΠΏΡ€ΠΈ использовании Ρ€Π°Π½Π½Π΅Π³ΠΎ (Π΄ΠΎ 3 сут) ΡΠ½Ρ‚Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ питания наблюдали статистичСски Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ сниТСниС риска развития ЭП Π½Π° 175,5 ΠΈ 137% случаСв. Π‘ΠΏΠ΅Ρ†ΠΈΡ„ΠΈΡ‡Π½ΠΎΡΡ‚ΡŒ ΠΈ Ρ‡ΡƒΠ²ΡΡ‚Π²ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ ΠΌΠΎΠ΄Π΅Π»ΠΈ составили 78,7 ΠΈ 82,8% соотвСтствСнно.Π’Ρ‹Π²ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΈ Π°Π»ΠΈΠΌΠ΅Π½Ρ‚Π°Ρ€Π½ΠΎΠΌ ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·Π΅ усугублСниС тяТСсти состояния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°, Π°Π»ΠΊΠΎΠ³ΠΎΠ»ΡŒΠ½Ρ‹ΠΉ Π³Π΅Π½Π΅Π· заболСвания, прогрСссированиС ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΏΠ΅Ρ‡Π΅Π½ΠΎΡ‡Π½ΠΎΠΉ ΠΈ ΠΏΠΎΡ‡Π΅Ρ‡Π½ΠΎΠΉ нСдостаточности статистичСски Π·Π½Π°Ρ‡ΠΈΠΌΠΎ ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΠ²Π°Π»ΠΈ риск развития ЭП. Π’ Ρ‚ΠΎ ΠΆΠ΅ врСмя Ρ€Π°Π½Π½Π΅Π΅ ΡΠ½Ρ‚Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠ΅ ΠΏΠΈΡ‚Π°Π½ΠΈΠ΅ способствовало Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠΌΡƒ сниТСнию риска этого ослоТнСния. ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Π½Π°Ρ прогностичСская модСль рСкомСндуСтся ΠΊ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡŽ Π² Ρ€ΡƒΡ‚ΠΈΠ½Π½ΠΎΠΉ клиничСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅.

    Π˜Π½Ρ‚Π΅Π³Ρ€Π°Π»ΡŒΠ½Ρ‹ΠΉ способ прогнозирования риска ΠΏΠ°Π½ΠΊΡ€Π΅Π°Ρ‚ΠΈΡ‚Π° послС эндоскопичСской Ρ€Π΅Ρ‚Ρ€ΠΎΠ³Ρ€Π°Π΄Π½ΠΎΠΉ Ρ…ΠΎΠ»Π°Π½Π³ΠΈΠΎΠΏΠ°Π½ΠΊΡ€Π΅Π°Ρ‚ΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ

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    The objective: development of a method for determining the individual risk of post-ERCP pancreatitis (PEP) before endoscopic intervention.Subjects and Methods. A prospective observational study of the results of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was performed in 1,210 patients. The primary end point was the development of PEP. Multiple regression logistic analysis was used to determine the risk of developing PEP.Results. A model of independent variables was determined, which significantly (p = 0.0001) affected the risk of developing PEP. Based on the results of the logistic analysis, regression coefficients were calculated for all significant patient-dependent factors (gender, age, preoperative level of amylasemia and bilirubinemia, and nature of the underlying disease). The risk of PEP decreased in men (by 47.5%), with an increase in the age of patients (for 1 year by 2.3%) and bilirubin (with an increase of 1 ΞΌmol/l by 0.3%) but increased with an increase in amylase activity blood serum (by 0.7% for each 1 U/l). A formula has been developed to assess the individual risk of PEP at the stage of preparing a patient for therapeutic ERCP.Conclusion. Analysis of patient-dependent factors makes it possible to reliably determine the risk of developing PEP. It was determined that a female gender, young age (under 40 years old), sphincter of Oddi dysfunction increased the risk of PEP, while a male sex, stenting of the main pancreatic duct, and jaundice reduced this risk. The use of the proposed formula will help predict a significant (p = 0.0001) degree of risk of PEP before performing primary therapeutic ERCP in a particular patient.ЦСль: Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚ΠΊΠ° способа опрСдСлСния ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡƒΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ риска развития пост-Π­Π Π₯ΠŸΠ“-ΠΏΠ°Π½ΠΊΡ€Π΅Π°Ρ‚ΠΈΡ‚Π° (ПЭП) Π΄ΠΎ выполнСния эндоскопичСского Π²ΠΌΠ΅ΡˆΠ°Ρ‚Π΅Π»ΡŒΡΡ‚Π²Π°.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ проспСктивноС Π½Π°Π±Π»ΡŽΠ΄Π°Ρ‚Π΅Π»ΡŒΠ½ΠΎΠ΅ исслСдованиС Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² Π»Π΅Ρ‡Π΅Π±Π½ΠΎΠΉ эндоскопичСской Ρ€Π΅Ρ‚Ρ€ΠΎΠ³Ρ€Π°Π΄Π½ΠΎΠΉ Ρ…ΠΎΠ»Π°Π½- Π³ΠΈΠΎΠΏΠ°Π½ΠΊΡ€Π΅Π°Ρ‚ΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ (Π­Π Π₯ΠŸΠ“) Ρƒ 1 210 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². ΠŸΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎΠΉ ΠΊΠΎΠ½Π΅Ρ‡Π½ΠΎΠΉ Ρ‚ΠΎΡ‡ΠΊΠΎΠΉ считали Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ ПЭП. Для опрСдСлСния риска развития ПЭП примСняли мноТСствСнный логистичСский рСгрСссионный Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ΠžΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½Π° модСль нСзависимых ΠΏΠ΅Ρ€Π΅ΠΌΠ΅Π½Π½Ρ‹Ρ…, которая достовСрно (p = 0,0001) влияСт Π½Π° риск развития ПЭП. По Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π°ΠΌ логистичСского Π°Π½Π°Π»ΠΈΠ·Π° вычислСны рСгрСссионныС коэффициСнты для всСх Π·Π½Π°Ρ‡ΠΈΠΌΡ‹Ρ… ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚-зависимых Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ² (ΠΏΠΎΠ», возраст, ΠΏΡ€Π΅Π΄ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π½Ρ‹ΠΉ ΡƒΡ€ΠΎΠ²Π΅Π½ΡŒ Π°ΠΌΠΈΠ»Π°Π·Π΅ΠΌΠΈΠΈ ΠΈ Π±ΠΈΠ»ΠΈΡ€ΡƒΠ±ΠΈΠ½Π΅ΠΌΠΈΠΈ, Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€ основного заболСвания). Риск ПЭП сниТался Ρƒ ΠΌΡƒΠΆΡ‡ΠΈΠ½ (Π½Π° 47,5%), ΠΏΡ€ΠΈ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠΈ возраста ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² (Π·Π° 1 Π³ΠΎΠ΄ Π½Π° 2,3%) ΠΈ уровня Π±ΠΈΠ»ΠΈΡ€ΡƒΠ±ΠΈΠ½Π° (ΠΏΡ€ΠΈ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠΈ Π½Π° 1 мкмоль/Π» Π½Π° 0,3%), Π½ΠΎ ΠΏΠΎΠ²Ρ‹ΡˆΠ°Π»ΡΡ ΠΏΡ€ΠΈ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠΈ активности Π°ΠΌΠΈΠ»Π°Π·Ρ‹ сыворотки ΠΊΡ€ΠΎΠ²ΠΈ (Π½Π° 0,7% Π½Π° ΠΊΠ°ΠΆΠ΄ΡƒΡŽ 1 Π•Π΄/Π»). Π Π°Π·Ρ€Π°Π±ΠΎΡ‚Π°Π½Π° Ρ„ΠΎΡ€ΠΌΡƒΠ»Π°, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‰Π°Ρ ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡƒΠ°Π»ΡŒΠ½Ρ‹ΠΉ риск ПЭП Π½Π° этапС ΠΏΠΎΠ΄Π³ΠΎΡ‚ΠΎΠ²ΠΊΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° ΠΊ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΡŽ Π»Π΅Ρ‡Π΅Π±Π½ΠΎΠΉ Π­Π Π₯ΠŸΠ“.Π’Ρ‹Π²ΠΎΠ΄. Анализ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚-зависимых Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ² позволяСт достовСрно ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΠΈΡ‚ΡŒ риск развития ПЭП. ΠžΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΎ, Ρ‡Ρ‚ΠΎ ТСнский ΠΏΠΎΠ», ΠΌΠΎΠ»ΠΎΠ΄ΠΎΠΉ возраст (Π΄ΠΎ 40 Π»Π΅Ρ‚), дисфункция сфинктСра Одди ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΠ²Π°Π»ΠΈ, Π° муТской ΠΏΠΎΠ», стСнтированиС Π³Π»Π°Π²Π½ΠΎΠ³ΠΎ панкрСатичСского ΠΏΡ€ΠΎΡ‚ΠΎΠΊΠ°, Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ ΠΆΠ΅Π»Ρ‚ΡƒΡ…ΠΈ сниТали риск развития ПЭП. ИспользованиС ΠΏΡ€Π΅Π΄Π»ΠΎΠΆΠ΅Π½Π½ΠΎΠΉ Ρ„ΠΎΡ€ΠΌΡƒΠ»Ρ‹ ΠΏΠΎΠΌΠΎΠΆΠ΅Ρ‚ ΠΏΡ€ΠΎΠ³Π½ΠΎΠ·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ Π΄ΠΎΡΡ‚ΠΎΠ²Π΅Ρ€Π½ΡƒΡŽ (p = 0,0001) ΡΡ‚Π΅ΠΏΠ΅Π½ΡŒ риска ПЭП Π΄ΠΎ выполнСния ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎΠΉ Π»Π΅Ρ‡Π΅Π±Π½ΠΎΠΉ Π­Π Π₯ΠŸΠ“ Ρƒ ΠΊΠΎΠ½ΠΊΡ€Π΅Ρ‚Π½ΠΎΠ³ΠΎ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°

    ΠŸΠ΅Ρ€ΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΏΡ€ΠΎΠ³Π½ΠΎΠ·ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ острого поврСТдСния ΠΏΠΎΡ‡Π΅ΠΊ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·ΠΎΠΌ

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    Relevance. The incidence of acute pancreatitis is growing worldwide, being one of the leading causes of hospitalization in urgent surgery. The most common complication of pancreatic necrosis (PN) in the aseptic phase is acute kidney injury (AKI), which is an independent risk factor for an unfavorable outcome.The objective was to develop a personalized risk model for AKI in the aseptic phase of pancreatic necrosis.Materials and methods. A comparative cohort study of the results of treatment of 502 patients with pancreatic necrosis was conducted. The primary endpoint was considered to be the development of AKI, for the development of a personalized model of the probability of its development in sterile pancreatic necrosis, binary logistic regression analysis was used.Results. A model of independent variables was developed that reliably (p < 0.001) determined that with an increase in age by 1 year, the probability of developing AKI increased by 2.3%, and with a history of chronic kidney disease in a patient – by 3.2 times.The same model demonstrates that the risk of AKI in patients with pancreatic necrosis with an increase in glomerular filtration rate by 1 mlΒ·min–1Β·1.73 m2 and with the use of balanced crystalloid solutions decreased by 5.0% and 3.0 times, respectively.The specificity of the model was 79.8%, sensitivity – 79.1%.Conclusion. The proposed model makes it possible to reliably predict the individual risk of AKI on the first day of hospitalization.ΠΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ. Π—Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡ‚ΡŒ острым ΠΏΠ°Π½ΠΊΡ€Π΅Π°Ρ‚ΠΈΡ‚ΠΎΠΌ растСт Π²ΠΎ всСм ΠΌΠΈΡ€Π΅, являясь ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· Π²Π΅Π΄ΡƒΡ‰ΠΈΡ… ΠΏΡ€ΠΈΡ‡ΠΈΠ½ госпитализации Π² ΡƒΡ€Π³Π΅Π½Ρ‚Π½ΠΎΠΉ Ρ…ΠΈΡ€ΡƒΡ€Π³ΠΈΠΈ. НаиболСС частым ослоТнСниСм ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·Π° (ПН) Π² Π°ΡΠ΅ΠΏΡ‚ΠΈΡ‡Π΅ΡΠΊΡƒΡŽ Ρ„Π°Π·Ρƒ являСтся остроС ΠΏΠΎΠ²Ρ€Π΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ ΠΏΠΎΡ‡Π΅ΠΊ (ОПП), ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ΅ являСтся нСзависимым Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠΌ риска нСблагоприятного исхода.ЦСль – Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚ΠΊΠ° пСрсонализированной ΠΌΠΎΠ΄Π΅Π»ΠΈ риска развития ОПП Π² асСптичСской Ρ„Π°Π·Π΅ ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·Π°.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΡΡ€Π°Π²Π½ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ΅ ΠΊΠΎΠ³ΠΎΡ€Ρ‚Π½ΠΎΠ΅ исслСдованиС Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² лСчСния 502 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅Ρ€ΠΎΠ·ΠΎΠΌ. ΠŸΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎΠΉ ΠΊΠΎΠ½Π΅Ρ‡Π½ΠΎΠΉ Ρ‚ΠΎΡ‡ΠΊΠΎΠΉ считали Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ ОПП, для Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚ΠΊΠΈ пСрсонализированной ΠΌΠΎΠ΄Π΅Π»ΠΈ вСроятности развития ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠΉ ΠΏΡ€ΠΈ ΡΡ‚Π΅Ρ€ΠΈΠ»ΡŒΠ½ΠΎΠΌ ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·Π΅ примСняли Π±ΠΈΠ½Π°Ρ€Π½Ρ‹ΠΉ логистичСский рСгрСссионный Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π Π°Π·Ρ€Π°Π±ΠΎΡ‚Π°Π½Π° модСль нСзависимых ΠΏΠ΅Ρ€Π΅ΠΌΠ΅Π½Π½Ρ‹Ρ…, достовСрно (p < 0,001) ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΡΡŽΡ‰Π°Ρ, Ρ‡Ρ‚ΠΎ ΠΏΡ€ΠΈ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠΈ возраста Π½Π° 1 Π³ΠΎΠ΄ Π²Π΅Ρ€ΠΎΡΡ‚Π½ΠΎΡΡ‚ΡŒ развития ОПП увСличиваСтся Π½Π° 2,3%, Π° ΠΏΡ€ΠΈ Π½Π°Π»ΠΈΡ‡ΠΈΠΈ хроничСской Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΏΠΎΡ‡Π΅ΠΊ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅ – Π² 3,2 Ρ€Π°Π·Π°. Π­Ρ‚Π° ΠΆΠ΅ модСль дСмонстрируСт, Ρ‡Ρ‚ΠΎ риск развития ОПП Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠ°Π½ΠΊΡ€Π΅ΠΎΠ½Π΅ΠΊΡ€ΠΎΠ·ΠΎΠΌ ΠΏΡ€ΠΈ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠΈ скорости ΠΊΠ»ΡƒΠ±ΠΎΡ‡ΠΊΠΎΠ²ΠΎΠΉ Ρ„ΠΈΠ»ΡŒΡ‚Ρ€Π°Ρ†ΠΈΠΈ Π½Π° 1 ΠΌΠ»βˆ™ΠΌΠΈΠ½β€“1/1,73ΠΌ2 ΠΈ ΠΏΡ€ΠΈ использовании сбалансированных кристаллоидных растворов сниТался Π½Π° 5,0% ΠΈ Π² 3,0 Ρ€Π°Π·Π° соотвСтствСнно. Π‘ΠΏΠ΅Ρ†ΠΈΡ„ΠΈΡ‡Π½ΠΎΡΡ‚ΡŒ ΠΌΠΎΠ΄Π΅Π»ΠΈ составила 79,8%, Ρ‡ΡƒΠ²ΡΡ‚Π²ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ – 79,1%.Π’Ρ‹Π²ΠΎΠ΄. ΠŸΡ€Π΅Π΄Π»ΠΎΠΆΠ΅Π½Π½Π°Ρ модСль позволяСт достовСрно ΠΏΡ€ΠΎΠ³Π½ΠΎΠ·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡƒΠ°Π»ΡŒΠ½Ρ‹ΠΉ риск ОПП Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ сутки госпитализации
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