ADVANTAGES OF EPIDURAL ANESTHESIA DURING THE APPLICATION OF PERITONEAL DIALYSIS METHOD DURING THE CHRONIC RENAL INSUFFICIENCY

S.B.IMAMVERDIYEV, E.A.GULIYEV, F.CH.ALMAMMADOV

Azerbaijan Medical University, Baku, AZERBAIJAN

Use of peritoneal dialysis method during chronic renal insufficiency is widely spread. The method has a number of undeniable advantages. Simple use of the method, rare occurrence of various complications, including hemodynamic complications as compared to the hemodialysis method enables its wide use. To carry out peritoneal dialysis, special dialysate solutions shall be injected into the small pelvis by means of a special cannulas, inserted into the abdominal cavity, 3-f times a day every 4 – 6 – 8 hours in the amount of 2-2,5 liters. Insertion of special cannulas into a small pelvis through abdominal cavity may be carried out with the use of various anaesthetization methods. Conduct of the operation with the of various anaesthetization methods is described in world literature. The main purpose of our investigation was to demonstrate advantages of the use of epidural anesthesia during the conduct of this operation. For this purpose 30 patients with chronic renal insufficiency, exposed to laparotomy for the conduct of peritoneal dialysis were divided into two groups subject to the used anaesthetization methods: The first group (10 patients) – insertion of a special cannula into a small pelvis was carried out under combined anesthesia (400 – 500 ml of 0.5% novocaine + intravenous talomonal anesthesia). The second group (20 patients) – the abovementioned operations were carried out with the injection of 15 ml of 0.5% bupivacaine + 50 mcg fentanyline into the epidural area. The assess the adequacy of the used anesthesia, the level of vasopressin and cortisol in plasma, as well general clinical presentations were examined. The shown hormones were examined by radioimmunologic method that is considered to be safer and more accurate. It was determined in the result of the conducted investigation that in the second group operations conducted under epidural anesthesia protect the patients from surgical trauma better than other methods. The use of epidural anesthesia showed better post-operative results of the intestinal function in the patients of the second group as compared to the patients of the first group.

RESULTS OF APPLY OF ANTIBIOTIC TREATMENT IN POST SURGICAL OPERATION PERIOD TAKING INTO ACCOUNT VAGINAL FLORA IN WOMEN OF REPRODUCTIVE AGE

H.B.ISAYEV, T.A.ALLAZOV, A.V.DADASHOVA

Scientific Surgical Center named after M.A.Topchubashov, Siyazan Regional Medical Diagnostic Center, Baku, Siyazan, AZERBAIJAN

Obtaining of information on condition of micro flora in women’s urinary-genital tracts in course of surgical treatment is of great importance both in treatment of surgical diseases and in diagnosis. Therefore study of epidemiology of vaginal micro flora of women in reproductive ages among the people living in specific territories can be useful for improvement of results of precaution and treatment of gynecological and surgical diseases. We carried out in recent 5 years bacteriological examination of about 1765 women with the purpose to study vaginal infection in women living in Siyazan – Shabran zone and who are in reproductive ages (17 – 35 ages). Obtained results have been estimated by 4 purity degrees as to jointly accepted classification: 1 degree purity of vagina has not been observed in women who were examined. In 39.2 % women 2^nd degree, in 44.1% women 3^rd and in 26.7% women 4^th degree purity of vagina has been observed. As respect to type of determined micro flora in 46.8% women - rod-like, in 42.9% women - rhizomorphous, in 10.3% women– mixed, in 22% women – bacterium, in 1.8% women – gonorrhea, 1.9% women – trichomoniasis, in 49.6% women – yeast has been determined. For the technical reasons clamidiosis, mycoplasmosis and ureaplasma have not been determined. In 205 women out of 1765 women who were examined were operated (appendectomy, hernioplasty, maternity out of childbed, cesarean operation, hemorrhoidectomy, stopping of anus fistula and split, proctocele, colpocystocele, mastitis, postinjection apostasis). In 32 (15.6%) patients 2^nd degree cleanness of vagina, in 114 (55.6%) patients 3^rd degree and in 59 (28.8%) patients 4^th degree purity of vagina observed. After surgical intervention antibiotic therapy has been applied to 155 patients (first group) basing upon sensitiveness of micro flora determined in vagina towards antibiotics, and in 50 patients (second group) it was applied not taking into account such sensitiveness. After surgical intervention in patients belonging to the first group has been observed festering of wound in 11 patients (1.5%), in second group the same was observed in 9 (4.5%) patients. Summarizing above mentioned we can come to such a conclusion that in surgical treatment of women living in towns first of all type of micro flora and its intensity should be determined and then antibiotic therapy should be carried out on the basis of determined sensitiveness of micro flora.

Date: 2014-12-28; view: 1000