卷 4, 编号 4 (2014)

Treatment of children with congenital tracheal stenosis is still a pressing issue both for surgeons and intensivists. Initially the interventions were performed in the setting of one-lung ventilation (OVL) using artificial circulation and in some cases extra-corporeal membrane oxygenation (ECMO) was applied. N.F. Filatov Children’s State Clinical Hospital No. 13 was the first hospital in Russia where 5 surgeries in children with developmental defects of trachea and bronchi who received ECMO intraoperatively were performed in 2013-2014. The intraoperative use of ECMO was essential due to several reasons: first, patients with congenital tracheal stenosis often suffer from inflammatory diseases of the lungs and upper respiratory tracts which in its turn leads to parenchymal insufficiency; second, tests with the usage of one-lung artificial ventilation show a considerable decrease in oxygenation and oxygen tension in the blood in this group of patients.

The thoracoscopic approach to a mediastinal mass is undoubtedly advantageous, although the dissection of the anatomical structures involved can potentially be challenging. We present a case of a thoracoscopic approach to a complex mediastinal mature teratoma, which was intimately adhered to the aortic arch and also compounded by a spontaneous tumor rupture at that site.

Magnetic foreign body in the digestive tract in children may have different ways to stay and outcomes. The authors present clinical examples of location, surgical removal of the magnetic bodies and the described case of complications as a result of multiple magnetic foreign bodies in the gastrointestinal tract. Developed clinical management of patients with suspected presence of magnetic foreign bodies in different sections of the gastrointestinal tract.

Congenital peripheral lymphedema can be primary, associated with malformation of the lymphatic system and secondary, becous of amniotic constrictions. The latter is extremely rare. Primary lymphedema cannot operate. In case of a great edema and a progressive course of primary lymphedema, it is right to apply anti-edema therapy, including manual lymphatic drainage and compression bandage. The article presentsthe the classification and differential diagnosis of congenital lymphedema, clinical examples and results of treatment.

Purpose of the study was to examine the clinical and functional characteristics of children with congenital keeled chest (CKC) prior to and following thoracoplasty. The work presents the results of examination of 84 children with CKC treated at the thoracic department of Andijan Regional Children’s Multipurpose Medical Center (Andijan, Uzbekistan) from 2007 to 2012. 72 (86%) boys with CKC predominated over 12 (14%) girls with the same diagnosis. Operations were performed with the help of thoracoplasty. Clinical and anamnestic method of examination, anthropometric methods, X-ray methods and clino-orthostatic test were used to study the activity of the sympathetic nervous system in all children. X-ray and thoracometric indices had a high correlation ratio leading to their recommendations as clinical criteria of severe chest deformity prior to operation and as a correlated index. Frequent detection of pathological types of COT (hyperdiastolic, asympathicotonic and sympathicoasthenic (56,4%)) characterized by insufficient activity of the sympathetic vegetative system is typical of children with CKC.

Article includes short historical review concerning blood gas analysis and mainly dedicated to such derived parameter as anion gap. Meaning of parameter in different critical situations is discussed. Pictured role of parameter for diagnostics of such syndrome as D-lactacidosis.