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Articolul urmator |
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Ultima descărcare din IBN: 2021-10-08 15:48 |
SM ISO690:2012 COVACI, Ana. Decompresia ductului limfatic toracic și asanarea laparoscopică ca etapă de corecție a ascitei cirogene . In: Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, 21-23 octombrie 2020, Chişinău. Chişinău: USMF, 2020, p. 402. |
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Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” 2020 | |||||||
Congresul "Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”" Chişinău, Moldova, 21-23 octombrie 2020 | |||||||
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Pag. 402-402 | |||||||
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Background. The mechanisms of cirrhotic ascites are very complex, being important the disturbances of the central lymphocirculation, with the formation of a lymphocirculatory block and the decrease of the drainage function of the thoracic lymphatic duct (TLD). Objective of the study. Evaluation of the efficiency of the central lymphocirculation reactivation (decompression of TLD) and laparoscopic drainage with fractionated postoperative lavage (in the treatment of SBP) for patients with liver cirrhosis and refractory ascites(RA). Material and Methods. The study included 91 patients with liver cirrhosis and RA, operated during 2007-2017, Child B/C - 16/75 (10,5 ± 1,18). They underwent TLD decompression (debridement and extensive mobilization of the cervical portion of TLD) and laparoscopic drainage with fractionated postoperative lavage with intraperitoneal introduction of therapeutic remedies for 3 days (antibiotics, lidase, dexamethasone). Results. Intraoperatively, after TLD debridement and forced respiration, it was observed the expansion of the cervical segment and the terminal portion of the duct by 4,65 ± 1,64 mm, p˂0,001. After intervention, diuresis has increased to all the patients (with 839,7 ± 448,02 ml, p<0,001). Early results of treatment: obvious regression, stabilization with minimal diuretic therapy - 54 patients (59,3%), moderate regression, stabilization and supportive diuretic therapy - 18 patients (19,8%) , necessary need for decompressive laparocentesis due to ascites tension - 12 patients (13,2%), temporary efficacy, subsequent progression of liver failure with death - 7 patients (7,8%). Conclusion. Cervical decompression of the TLD and laparoscopic drainage with fractional postoperative lavage could be an effective method in treatment of RA in patients with decompensated liver cirrhosis.. The proposed method is pallyative and permits temporary amelioration of life quallity. |
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Cuvinte-cheie cirrhogenous ascites, thoracic lymphatic duct, ascită cirogenă, duct limfatic toracic |
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