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5невой) аппаратом внешней фиксации положительные результаты составили 92,3% и 93,8% случаев соответственно.
3. Авторские конструкции стержневых АВФ, не уступая по жесткости фиксации аппарату Илиза-рова, позволили снизить трудоемкость наложения аппарата, провести эффективное, малотравматичное лечение различных видов диафизарных переломов бедренной кости у детей с возможностью выполнения ранних реабилитационных мероприятий.
4. Предложенные варианты чрескостного остеосинтеза привели к сокращению сроков стационарного лечения в 1,8 и 1,4 раза соответственно, а так же сроков консолидации на 20,8% и 12,8% по сравнению со спицевыми и спице-стержневыми аппаратами соответственно. На фоне их применения достоверно удалось снизить количество ошибок и осложнений при лечении детей с переломами диа-физа бедренной кости.
Список литературы
1. Анкин Л.Н. Травматология (Европейские стандарты) / Л.Н. Анкин, Н.Л. Анкин. - М., 2005. -496 с.
2. Бейдик О.В. Моделирование наружного чрескостного остеосинтеза / О.В. Бейдик, К.Г. Бутовский, Н.В. Островский, В.Н. Лясников. - Саратов, Изд-во Саратовского медицинского университета, 2012. - 198 с.
3. Илизаров Г.А. Основные принципы остео-синтеза компрессионного и дистракционного // Ортопед, травматол. - 1971. - №1. - С. 7-11.
4. Краснов А.Ф. 30-летний опыт лечения травматолого-ортопеди-ческих больных методом Илизарова / А.Ф. Краснов, Г.П. Котельников, М.И. Бабкова, Ю.М. Складчинов // Гений ортопед. -2016. - №2-3. - С. 27-28.
5. Кожевников О.В. Разработка систем высокотехнологичного стабильного остеосинтеза проксимального отдела бедренной кости у детей / О.В.
Кожевников // Медицинский альманах. - 2012. -№1(20). - С. 137-141.
6. Литвишко В.А. Лечение диафизарных переломов бедренной кости аппаратами внешней фиксации / В.А. Литвишко // Ортопедия, травматология и протезирование. - 2014. - №2 (595). - С. 1622.
7. Меркулов В.Н. Диагностика и лечение переломов длинных костей, осложненных нарушением консолидации костных отломков, у детей и подростков / В.Н. Меркулов, А.И. Дорохин, О.Г. Соколов, Д.С. Мининков // Вестник Российской академии медицинских наук. - 2008. - №9. - С. 2024.
8. Мюллер М.Е. Руководство по внутреннему остеосинтезу. Методи-ка, рекомендованная группой АО (Швейцария) (пер. на русс. яз.) / М.Е. Мюллер, М. Алльговер, Р. Шнайдер, X. Виллинегер. -М.: Изд-во AdMarginem, 1996. - 750 с.
9. Попсуйшапка А.К. Лечение несращения отломков кости после диафизарного перелома / А.К. Попсуйшапка, А.В. Литвишко, В.В. Григорьев, Н.А. Ашукина // Ортопедия, травматология и протезирование. - 2016. - №1 (594). - С. 34-41.
10. Тюляев Н.В. История развития и современное состояние проблемы лечения травм конечностей методом чрескостного остеосинтеза (Обзор лите-ратуры) / Н.В. Тюляев, Т.Н. Воронцова, Л.Н. Соломин, П.В. Скоморошко // Травматология и ортопедия России. - 2014. - № 2 (60). - С. 179-190.
11. Черныш В.Ю. Способ репозиции дисталь-ного фрагмента при остеосинтезе бедренной кости аппаратами внешней фиксации / В.Ю. Черныш, А.Я. Лобко, А.А. Антонов [и др.] // Ортопедия, травматология - 2011. - №2. - С. 83-85.
12. Яндиев С.И. Обоснование эффективности системы закрытого интрамедуллярного остеосин-теза у детей с диафизарными переломами бедренной кости (клинико-экспериментальное исследование): автореф. дисс ... д-ра мед.наук / С.И. Яндиев. - М., 2011. - 51 с.
TECHNOLOGY OF DEVELOPMENT OF GROUP ACTIVITY AS A PRIORITY OF THE
DEPARTMENT OF SURGERY №1
Moroz P.
PhD, Assistant of the Department of Surgery № 1 Bukovynian State Medical University Kotelban A.
PhD, Associate Professor of the Department of Pediatric Dentistry
Bukovynian State Medical University
Abstract
Scientific and technological progress, which has covered all areas of medicine, encourages not only the active introduction of new technologies in the treatment process, but also the development of new science-intensive technologies for diagnosis, treatment of patients and prevention of various complications.
Introduction
The staff of the Department of Surgery №>1 BSMU for many years is the locomotive of scientific and technological progress in surgery in Bukovina.
The Clinic of the Department of Surgery is a regional methodological center for providing surgical
care to the population of Chernivtsi region. The base of the clinic is the Department of General, Thoracic, Vascular Surgery and Proctology of Chernivtsi Regional Clinical Hospital, which encourages a wide range of scientific, technical and technological research.
The clinic of the department performs a wide range of modern surgical interventions on the esophagus, digestive organs, lungs, rectum, blood vessels, developed methods of diagnosis, surgical and conservative treatment and prevention of postoperative complications. Employees of the department were the first in Bukovyna, back in 1996, to perform laparoscopic surgery in planned and emergency surgery, and in 2020 performed hemicolonectomy.
Methodological approach for self-improvement of the team
In 2011, the Regional Center for Minimally Invasive Surgery and Gynecology was established on the basis of the Department of Surgery and departments of the regional clinical hospital. The task of the Center was to more widely introduce into the treatment process methods of laparoscopic and thoracoscopic surgical interventions, development of new and improvement of existing methods of operations.
The Center has implemented laparoscopic operations for acute appendicitis, acute and chronic cholecystitis, inguinal and femoral hernias, hernia of the esophageal orifice of the diaphragm, esophagus, with some complications of peptic ulcer disease, conjuncti-val disease, thorax, pleura, thymus, Raynaud's disease, performed transthoracic neurophrenicotomy developed by the staff of the department. With the involvement of gynecologists, surgical interventions are performed for infertility, ovarian cysts, salpingitis, ectopic pregnancy, uterine fibroids.
Laparoscopic interventions in emergency surgery have been introduced - appendectomies, viscerolysis, autopsy and rehabilitation of delimited peritoneal abscesses are performed. These operations are performed mainly by employees of the department.
The Center for Minimally Invasive Surgery and Gynecology trains doctors at the postgraduate stage of training, provides consulting and methodological assistance to medical institutions of the region.
Theoretical and practical part
In recent years, the staff of the department is actively conducting research to study the influence of genetically determined factors on the course of acute surgical diseases of the abdominal cavity. This latest scientific direction allows not only to reveal new links in the pathogenesis of acute surgical diseases (peritonitis, pancreatitis, intestinal obstruction), but also to develop highly informative methods for predicting the development and features of these diseases. This radically changes not only the existing criteria for their diagnosis, but also the principles of treatment tactics - conservative therapy and surgical interventions aimed at improving the results of treatment and prevention of postoperative complications.
Limited high-cost technological equipment of the clinic encouraged the staff to develop science-intensive low-cost and low-cost technologies for surgical interventions, which allow existing means to ensure higher reliability of various stages of the operation, reduce the risk of complications, achieve high treatment results.
Among such methods are new types of intestinal sutures, methods of fixing and protecting the line of anastomoses, intubation of the intestine, local supply of
drugs, sanitation of the peritoneal cavity, etc. All these methods are protected by patents and implemented far beyond Bukovina.
One of the priority scientific and practical directions of the Department of Surgery is the development of methods for early diagnosis and effective treatment of various forms of peritonitis. Employees of the department proposed new informative methods for diagnosing acute peritonitis and its complications, developed effective methods of surgical interventions, which are protected by patents and used far beyond Ukraine. Recognition of the priorities of scientists on this issue is evidenced by their numerous speeches at scientific congresses in Austria, Moldova, Russia, Poland, publications in the United States, Canada, Israel, Germany, Portugal, Spain and others. The staff of the department published 5 monographs on this topic, defended 5 doctoral and 14 candidate dissertations, received more than 40 A patents and copyright certificates for inventions, held numerous conferences, symposia and congresses.
Since the founding of the department, one of the leading areas of its scientific and practical activities has been the study of various aspects of endemic goiter in Bukovina and the development of effective methods of treatment. Until now, the department remains the only scientific and practical center in Bukovina for surgical treatment of thyroid diseases.
The vast majority of employees of the department are surgeons of the highest category, who are constantly on duty in the departments of the hospital, regional sanitary aviation, often go to the areas of the region, where they implement the developed methods.
In the thoracic department, thoracoscopic operations are performed for various diseases of the lungs, pleura and interstitium.
Technological innovations - colonoscopic surgical interventions, electric welding of tissues, methods of diagnosis and treatment of nonspecific ulcerative colitis and Crohn's disease - are widely used in the proctology department.
The department has an active student research group, where students of different courses not only learn the skills of surgical manipulations, surgical interventions, but also learn from the experience of their mentors and conduct clinical and experimental research. With their scientific achievements, the group members speak at conferences of various levels, including international ones. They are winners of many competitions and congresses.
Considerable attention is paid to the training of students and young surgeons. 8 textbooks have been published, a computer test program on surgery has been developed. The latest technologies are widely used in the educational process - live broadcasts of operations from the operating room to the classroom, own, videos, simulators, computer programs.
The department is a base for training interns in the specialty "Surgery". Since 2001, the department conducts pre-certification training and internship cycles for surgeons, thematic improvement courses in minimally invasive surgery, proctology, vascular and thoracic surgery. More than 550 doctors were involved in postgraduate studies.
Conclusion
The staff of the Department of Surgery not only preserves and multiplies the traditions laid down at the founding of the department, but also forms new, promising areas of activity aimed at implementing the latest teaching technologies, scientific substantiation of diagnosis and effective treatment of patients, development of new technologies.
References
1. Кафедра xipyprii' №1 [Електронний ресурс]. - Режим доступу: https://www.bsmu.edu.ua/hi-rurgiyi-1/
2. Белянина И.Н. Познавательные барьеры студентов ВУЗа и педагогические условия их преодоления / И.Н. Белянина, И.В. Богомаз // Вестник ТГПУ. - 2014. - №2. - С. 114-116.
3. Дичка 1.А. Використання сучасних тех-шчних засобiв в процеа навчання шоземних сту-денпв / 1.А. Дичка, В.1. Прохоров, £.С. Сулема. -К.: Кш'в. нац. торг.-екон. ун-т, 2002.- С. 113-121.
4. Щдвищення якосп освгги через оволодшня спещальними фаховими компетентностями / Л. В. Смаглюк, М. В. Трофименко, Г. В. Воронкова [та ш.] // Актуальш питания контролю якосп освгги у вищих навчальних закладах: матерiали наук.-практ. конф. з мiжнар. участю. -Полтава, 2018. - С. 220222.
5. Лопанова Е.В. Организация студентоцен-трированного обучения в медицинском ВУЗЕ/ Лопанова Е.В., Галянская // Международный журнал прикладных и фундаментальных исследований. -2015. - № 8-4. - С. 751-754; URL: https://ap-pliedresearch.ru/ru/artide/view?id=7235 .
6. Лещенко Т. О. Щрофесiоналiзм стлку-вання в структурi педагогiчноi майстерностi викла-дача вищоi медичноi школи / Т. О. Лещенко, В. Г. Юфименко // Сучасш технологii' управлiния нав-чальним процесом у вищих медичних навчальних закладах: матерiали навч.-наук. конф. з мiжнар. участю. - Полтава, 2014. - С. 124-125.
КЛИНИКО - ПАТОГЕНЕТИЧЕСКИЕ АСПЕКТЫ ФОРМИРОВАНИЯ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕК ПРИ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ
Муркамилов И.Т.
Кандидат медицинских наук, и.о. доцента, Кыргызская государственная медицинская академия им. И.К. Ахунбаева,
г. Бишкек, Кыргызстан ORCID:0000-0001-8513-9279 Сабиров И.С. Доктор медицинских наук, профессор, ГОУ ВПО Кыргызско-Российский славянский университет,
г. Бишкек, Кыргызстан ORCID: 0000-0002-8387-5800 Фомин В.В.
Доктор медицинских наук, профессор, член-корреспондент РАН, ФГАОУ ВО Первый МГМУ им. И.М. Сеченова (Сеченовский Университет),
г. Москва, Россия ORCID:0000-0002-2682-4417 Муркамилова Ж.А. Заочный аспирант, Медицинский факультет, ГОУ ВПО Кыргызско-Российский славянский университет,
г. Бишкек, Кыргызстан ORCID:0000-0002- 7653-0433 Юсупов Ф.А. Доктор медицинских наук, профессор, Медицинский факультет ОшГУ, г. Ош, Кыргызстан ORCID:0000-0003-0632-6653
