Khadzhyyev O. Optimization of surgical treatment of patients with perforated gastric and duodenal ulcer (clinical and experimental study)

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0502U000075

Applicant for

Specialization

  • 14.01.03 - Хірургія

14-02-2002

Specialized Academic Board

Д 64.600.01

Kharkiv National Medical University

Essay

The dissertation is devoted to the problems of pathogenesis of ulcer formation and the mechanism of development of smooth-muscle insufficiency in patients with perforated gastroduodenal ulcer. Main pathogenetic mechanisms of gastric ulcer formation as well as development of motor-evacuation disturbances of the alimentary tract after vagotomy and stomach resection were studied in the experiment performed on 126 white rats and in the clinic (751 patients investigated with clinico-biochemical, histochemical, ultrastructural, x-ray, electroenteromyography, endoscopy as well as objective methods). In the experiment it was established that the main cause of ulcer formation was disturbance of blood circulation at the microcirculation level based on serotonin insufficiency. Vagotomy performed in the experimental animals aggravated serotonin insufficiency. Exogenous administration of serotonin eliminated serotonin insufficiency and provided quick healing of the experimental ulcer. The clinical study demonstrated that perforating ulcer is surrounded by considerable destructive and degenerative changes. In 66% of the operated patients disturbances of the function of the stump of the resected and vagotomized stomach and the lower portions of the alimentary tract, which were stable in 18% of cases in spite of the used highly effective anticholine-esterase drugs, were observed. Early post-operative administration of serotonin adipinate according to the original protocol to the patients with perforated duodenal and gastric ulcer eliminated smooth-muscle insufficiency and microcirculation disorders in the mucous membrane.

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Реферат-текст.doc

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