Perepelitsa S. Assessment of long-term results of treatment of chronic ischemia of the distal upper extremities

Research objec - chronic distal ischemia of overhead limb; Aim of the research is to improve the results of patients treatment with the chronic distal ischemia of overhead limb when a reconstructive operation is impossible, due to choosing the most effective method of thoracic sympathectomy on the basis of estimation of remote results; Methods - clinical, laboratory, doplerografy, reovazografy, laser doplerfloumetry, transcutanic oxygemometry, mathematicall; The novelty of the obtained results consists in that first on the basis of study of direct, nearest and remote results of different variants of thoracic sympathectomy and conservative treatment of patients with unreconstructable chronic distal ischemia of overhead limb the the critical analysis of unsatisfactory results was conducted, their reasons are educed, what measures on their prophylaxis and corrections among that original method of intraoperation sympathectomy complete control; Results: advantage of videothoracoscopic sympathectomy was shown and expediency of its implementation is reasonable for the patients with an unreconstructable chronic distal ischemia of overhead limb. It is set that positive results in a remote period are got mainly at the phenomenon of Raynaud's and initial stage II of ischemia. Reasons of unsatisfactory results of operative treatment are educed in different terms. In the nearest postoperative period it is possible to consider incomplete desympatization reason of relapse, with the purpose of her prophylaxis original method of control intraoperation sympathectomy complete control. In a remote postoperative period for 2/3 patients the return of symptoms of ischemia was marked, but they carried more soft and of high quality, that explained by development of denervation hypersensitiveness of vessels of acral zones to the circulatory catecholamins, maximally be leveled by systematic complex antirecurrent therapy; It is inculcated - in medical practice, in an educational process; Sphere - medical practice.