http://ir.librarynmu.com/handle/123456789/16486 2026-04-07T03:21:05Z http://ir.librarynmu.com/handle/123456789/1721 Название: Ключові аспекти в лікуванні гострого некротичного панкреатиту Авторы: Ковальська, І. О.; Дронов, О. І.; Задорожня, К. О. Краткий осмотр (реферат): Key aspects of modern surgical approaches in the treatment of acute necrotic pancreatitis Dronov O.I., Kovalska I.O., Horlach A.I., Zadorozhnya K.O. National Medical University named after O.O. Bogomolets, Department of General Surgery № 1, Kyiv Kyiv center of surgery for liver, biliary tract and pancreas named after V.S. Zemskov, Kyiv Abstract Objective to set indications to minimally invasive interventions in patients with acute necrotizing pancreatitis considering pheses, complications and morphological features of disease. Materials and methods. The clinical data of 1572 patients with acute pancreatitis were analyzed. Diagnosis and treatment algorithm was used considering pathological stages of acute pancreatitis. New methods of minimally invasive necrozectomy, percutaneous drainage of fluid collections, methods of intraabdominal hypertension management were surgical proposed for acute infected necrotizing pancreatitis treatment. Results and discussion. Treatment tactics depended on the phase of acute pancreatitis. On the early stage using of different types of interventions was limited. The timing of minimally invasive drainage of fluid collections is strictly limited due to possible colonization of fluid and necrotic collections with microorganisms, and as a result infectious complications. Infected pancreatic necrosis requires drainage with increasing diameter of catheter. Percutaneous catheter drainage was successful as final treatment in 5,1 % cases in group of patients with acute infected necrotizing pancreatitis. In 64,7% of cases percutaneous catheter drainage was helpful in avoiding general infections complications, and on late stage surgical debridement was performed. Conclusions. Treatment of acute severe pancreatitis requires complex multidisciplinary approach, with attention to local and systemic complications. 2018-01-01T00:00:00Z http://ir.librarynmu.com/handle/123456789/1720 Название: Результати застосування хімічної деструкції в комплексному лікуванні вогнищевої патології печінки Авторы: Ковальська, І. О.; Дронов, О. І.; Козачук, Є. С.; Бакунець, П. П. Краткий осмотр (реферат): Objective. To estimate the immediate results of application of chemical destruction with 10% solution of calcium chloride in complex of treatment in the patients, suffering focal hepatic pathology. Маterials and methods. In 2012 – 2019 yrs, using chemical destruction, the impact was delivered towards 104 tumoral foci (range from 1 tо 4) in the patients, suffering hepatocellular carcinoma (23.7%), colorectal cancer metastases (55.3%) and in noncolorectal cancer (21.1%). The foci diameter have constituted at average (2.60 ± 1.24) сm (in 1.0 – 4.0 сm range). Chemical ablation was performed, using injections of 10% solution of calcium chloride. Side –effects and answer of tumoral foci were estimated. Results. The specific postoperative complications rate (formation of abscesses in zone of destruction, development of hematomas and biliomas) have constituted 10.5%. There were observed a complete answer in the foci 1.0 – 1.5 сm in diameter, while the disease progress – concerning the foci 3,8 – 4,2 сm in diameter. Local recurrence have occurred in 15.8% patients. The answer degree trustworthily depended upon the tumoral foci density (r=0.529, р < 0.001). Including, complete answering was observed in 76.9% hypodense, 23.1% іsodense foci, and partial – concerning 37.8% hypodense, 29.7% іsodense and 32.4% of the foci of mixed structure. Stabilization of the disease was diagnosed, concerning 15.0% іso – and hypodense, 40.0% hyperdense and 45.0% with the foci of mixed structure, while a progress – concerning 85.7% hyperdense and 14.3%of the foci of mixed density. Conclusion. Іntratumoral injection of 10% solution of calcium chloride in the treatment of focal hepatic pathology is not accompanied by severe specific complications and mortality, the patients are survive the procedure satisfactory, which may be applied as a local tumoral control of tumoral foci up to 3.0 сm in diameter. 2019-01-01T00:00:00Z http://ir.librarynmu.com/handle/123456789/1716 Название: Freezing dynamics 10% calcium chloride solution with liquid nitrogen in vitro Авторы: Kovalska, I.; Dronov, O.; Kozachuk, Y.; Khomenko, D.; Bakunets, P. Краткий осмотр (реферат): Relevance. Cryosurgical method is method of ultra-low temperatures local application for complete destruction of the pathological focus. Nowadays, question of cryosurgery radicality remains unsolve, because of inability to achieve lethal for tumor cells temperatures in depth from cryoapplicator.That`s why, attempts of cryodestruction improving are still keep going by developing methods of ultra-low temperatures cytodestructive effect potentiation, particulary, by their combination with chemical agents. Objective of the study was to determine the peculiarities of changes in temperature indices 10 % CaCl2 solution freezing in comparison with 0,9 % sodium chloride solution (0,9 % NaCl) in vitro. Materials and methods. Dynamic of low-temperatures changes were measured at control depths of 3, 8, 13, and 18 mm in 10% СаСl2 and 0.9% NaCl solutions by a four-channel measuring thermocouple complex KIIT-4. Cryo-tool of the original design was used for freezing. Cryoagent - liquid nitrogen (temperature -1800C). The temperature indices were detected during 10-minute exposure to liquid nitrogen. Results. During cryogenic exposure for 10 minutes at a distance of 13 and 18 mm from the cryoprobe, the mean temperatures in 10 % CaCl2 were significantly lower than 0,9 % NaCl (p <0,05). At control depths from 5th and 10th minute of exposure in 10 % CaCl2 the temperatures were significantly lower than 0,9 % NaCl (p <0,001). Conclusion. Consequently, 10 % CaCl2 can potentiate in vitro freezing processes and can be used to further improvemnt cryosurgery efficiency in vivo. 2018-01-01T00:00:00Z http://ir.librarynmu.com/handle/123456789/1686 Название: Оцінка безпечності внутрішньопечінкового введення 10 % розчину кальцію хлориду у щурів лінії WISTAR: експериментальне дослідження Авторы: Ковальська, І. О.; Дронов, О. І.; Земсков, С. В.; Козачук, Є. С.; Бакунець, П. П.; Жулевич, І. В. Краткий осмотр (реферат): SUMMARY. The aim of experimental study was to evaluate the safety of intrahepatic administration of 10 % calcium chloride solution in vivo. Material and Methods. The experiment was performed on 26 adult Wistar rats. Intrahepatic administration of 10 % calcium chloride was performed once. The dose was 5.0 mg/100.0 g of body weight of the animal. Average dose was (0.16±0.03) ml. There were evaluated: blood count test, liver function tests, ionized calcium concentration, specific complications, mortality. The follow-up time: 1, 3, 5, day for blood count test and liver samples and 1, 5, 10 minutes for ionized calcium. Complications and mortality were assessed up to 21 days. Results. On the 1st and 3rd day, changes in the parameters of general blood count and liver tests were characterized by a decreasing of hemoglobin rates (p=0.004) and increasing of leukocytes count (p=0.005), levels of total bilirubin (p=0.005), ALT (p=0.005), AST (p=0.005), alkaline phosphatase (p=0.005) as compared to baseline. On the 5th day, these parameters were normalized to baseline: hemoglobin (p=0.366), leukocytes (p=0.051), total bilirubin (p=0.469), ALT (p=0.575), AST (p=0.959), alkaline phosphatase ( p=0.169), respectively. Increasing of ionized calcium concentration in the rats blood serum in the first minute compared with the initial (p=0.005) was not accompanied by fatal consequences. Changes in all hematological parameters occurred within the referent rates and were not accompanied by clinical manifestations. Postoperative complications and mortality were not associated with intrahepatic administration of the drug. Conclusion. Intrahepatic administration of 10 % calcium chloride solution at a dose of 5.0/100.0 mg of body weight of an animal is not accompanied by impaired liver function, homeostasis of blood calcium ions, the development of local complications and mortality. 2019-06-01T00:00:00Z