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В статье представлены данные о применении навигационных технологий с лечебно-диагностической целью у больных с панкреонекрозом. Пункции под УЗ-наведением проведены у 76 больных (дважды они дополнены КТ-навигацией) для дренирования жидкостных образований: оментобурсита, панкреатогенных абсцессов, скоплений жидкости в забрюшинном пространстве и в малом тазу. Определены показания к пункционному дренированию и установке дренажей при комплексном лечении панкреонекрозов.
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The aim: to study effect percutaneous puncture drainage in integrated therapy of pancreonecrosis. Navigation tecnologies controlled by ultrasound and roentgen has been applied to 76 patients for drainage of accumulation of inflammation liquid. The latter has been analysed for amylase activity and bacteria. As a rule multiple needle punctures (51 cases) have been used in one-two days. Sometimes ordinary drains have been practised (18 cases). At last in 7 cases both methods have been combined. Puncture method used to be effective for treatment of encapsuled and diffuse fermentative peritonitis and of localyzed abscessing pancreatitis. Drainage of encapsuled peritonitis in bursa omentalis in aseptic inflammation phase in 12 cases has resulted in abortive process of pancreonecrosis. Puncture treatment of localyzed abscessing pancreatitis situated in the head of pancreas and in the body of the pancreas turned out to be effective in 14 cases in the phase of purulent complications. Treatment of these patients took 25 to 62 days and there were no lethal outcome.
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