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17Таблица 3
Стоимость затрат на амортизацию оборудования и медикаменты, необходимых для изготовления полных _съемных протезов в зависимости от метода изготовления_
Метод изготовления полного съемного протеза Затраты на амортизацию Затраты на медикаменты ИТОГО
3D принтер 572,62 2083,40 2656,02
Традиционный способ 25,06 1631,10 1656,16
Таким образом, наименее дорогостоящей технологией является изготовление полных съемных протезов традиционным способом, стоимость затрат на изготовление полных съемных протезов с помощью 3D принтера Asiga Max на 54,9% дороже, что объясняется затратами на дорогостоящий фотополимерный материал.
Заключение
Изготовление полных съемных протезов традиционным способом наименее затратное и экономически более выгодно по сравнению с цифровым методом изготовления с помощью 3D принтера Asiga Max UV.
Литература
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8. Путеводитель по стоматологии ортопедической (Стоматологическая поликлиника) / В.Д. Вагнер, В.М. Семенюк, О.В. Чекунков. - М.: Мед. кн.; Н. Новгород: НГМА, 2004 (ПИК ВИНИТИ). -579
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POSSIBILITIES OF OZONE THERAPY IN THE TREATMENT OF APPENDICULAR PERITONITIS
IN CHILDREN (LITERATURE REVIEW)
Shamsieva L.A.
5-year student of the faculty ofpediatrics, Samarkand state medical institute, Atakulov J.
MD, professor at the department of pediatric surgery, Samarkand state medical institute, Djalolov D.
5-year student of the faculty ofpediatrics, Samarkand state medical institute, Samarkand, Republic of Uzbekistan
ABSTRACT
The treatment of peritonitis is one of the most difficult tasks facing surgery. This is especially acute in the treatment of common forms of peritonitis. Appendicular peritonitis is one of the most dangerous purulent-inflammatory diseases in children. In recent years, informations about the successful use of ozone in clinical practice in different groups of patients with surgical and general therapeutic profile with endo - and exotoxicosis of various severity have become more and more frequent in the medical literature. High concentrations of ozone have a toxic effect and are used to control microflora. An increase in the antibacterial activity of many antibiotics and antiseptics was detected during ozonation. The article presents data on the possibilities of using ozone therapy in the treatment of common appendicular peritonitis. The main properties of ozone therapy in peritonitis conditions are analyzed.
Keywords: peritonitis, ozone therapy, bactericidal action, children.
Purpose of the research: To summarize data on the possibilities of using ozone therapy in the treatment of common appendicular peritonitis.
The therapeutic effect of ozone therapy is based on oxidative "stress", which determine the metabolic and neuro-endocrine rearrangement in the body, aimed at restoring the homeostatic balance of redox processes. The peculiarity of ozone therapy is that ozone, actively participating in the regulation of oxygen metabolism, effectively uses energy substrates and stimulates the restoration of adaptive and compensatory subcellular structures [3, p. 42-43].
In recent years, reports on the successful use of ozone in clinical practice in different groups of patients with surgical and general therapeutic profile with endo - and exotoxicosis of various severity have become more and more frequent in the medical literature. Low antibacterial activity of chlorhexidine, dioxidine and furacilin to Staphylococcus, Proteus, Pseudomonas and Escherichia coli was observed. Thus, at 10-minute exposure, 15% - 20% of Proteus colonies died, while there was no bactericidal effect on Pseudomonas aeruginosa. At the same time, the effect of ozonated antiseptics and distilled water was fatal for 100% of the strains of these microbes within the first minute [3, p. 46; 7, p. 27-32].
According to the literature, ozone in concentrations from 1 to 5 mg / l leads to the death of 99.9% of E. coli, Streptococcus faecalis, Mycobacterum tuberculosis, Cryptosporidium parvum, Varavium, etc. for 420 minutes. At a concentration of 0.1 mg / l, even the destruction of very persistent spores of Pennicilinum notatum took 15-20 minutes. An increase in the sensitivity of microorganisms to the bactericidal action of the complement when exposed to ozone has been demonstrated. Ozone solutions are very effective against methicillin-resistant Staphylococcus aureus [5, p. 238; 12, p. 237-244; 13, p. 57-61).
In addition to the bactericidal effect, most authors found a noticeable acceleration of the healing dynamics of purulent wounds and the elimination of General and local symptoms of inflammation [14, p. 374-379].
According to Miroshin S. I. et al. with local ozone therapy, wounds were cleaned 4-5 days earlier from the purulent-necrotic discharge and began to fill with granulations in comparison with conventional methods of treatment, with the simultaneous disappearance of signs of inflammation and purulent intoxication [11, p. 56].
A number of authors have applied systemic ozone therapy for RAP against the background of multiple organ failure [1, p. 4]. there Was an improvement in peripheral and microcirculatory blood flow of the peritoneum, improvement and normalization of intestinal peristalsis, reduction and elimination of exudate accumulation in the abdominal cavity, as well as a decrease in fibrin on the peritoneum and intestinal loops [7, p. 27-32; 8, p. 5].
Laberko L. A. et al., proposed correction of manifestations of enteral insufficiency syndrome in common peritonitis using enteral ozone lavage. They presented an analysis of the effectiveness of enteral ozone lavage in the complex treatment of patients with advanced per-
itonitis, and showed that small bowel lavage with ozo-nated saline solution through a nasointestinal probe in the postoperative period can effectively eliminate pathological intraluminal bacterial contamination, reduces the toxicity of enteral contents and leads to a significant improvement in the functional parameters of the small intestine and the results of treatment in general [10, p. 82-87].
Ozone in therapeutic concentrations, both with local and systemic use, stimulates the phagocytic activity of polynuclears.
Intravascular infusion of solutions containing ozone at a concentration of 4-6 mg/l led to the mobilization of the humoral link of anti-infective protection -an increase in the phagocytic activity of neutrophils, an increase in the absorption capacity of test microbes by phagocytes, and an increase in the phagocytosis completion index.
There is an assumption that the parenteral use of ozone at the level of intracellular mechanisms stimulates the activity of enzymes of antibacterial protection of neutrophilic leukocytes [2, p. 10-13; 5, p. 51].
According to some authors, when blood is ozo-nated, the number of neutrophils involved in phagocytosis increases from 14% to 24% within 10 minutes and reaches 26 % by 15 minutes, remaining at this level for 3 days. The absorption capacity increases accordingly from 0.3 to 0.7 and then to 2.7 by 15 minutes [3, p. 16; 6, p. 84).
The phagocytosis completion index increases from 0.72 to 1.20. The pronounced immunocorrective and antibacterial properties of ozone made it possible to achieve significant success in the treatment of RAP, reduce the number of postoperative complications by 1.8 times and reduce postoperative mortality from 32.6% to 18.9% [9, p. 23].
A. M. Shamsiev et al., using ozone therapy in the prevention and treatment of postoperative abdominal abscesses in children with RAP, concluded that ozone has a bactericidal, antihypoxic, detoxifying effect, and also has an immunomodulatory effect [13, p. 57-61].
Thus, local and systemic ozone therapy opens up new prospects for the treatment of RAP, in particular, in patients with multiple organ failure syndrome. Most researchers do not note any side, toxic, mutagenic or teratogenic effects of ozone therapy when the recommended dosages are observed. Analyzing the literature data on ozone therapy of common purulent peritonitis, clinical and experimental data indicate that in addition to the bactericidal effect of ozone has:
- antihypoxic effect;
- immunomodulatory effect;
- detoxification effect.
In conclusion, we can say the following: many aspects of the treatment method under consideration leave a wide field for further study. Such as: the dosage and concentration of ozone in the solutions used in their local and systemic use, depending on the phases of peritonitis and the degree of intoxication, bacterial contamination of the peritoneum; parameters of negative effects and side effects on the patient's body, and many others.
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