卷 5, 编号 1 (2015)

This article reviews the experiences of the academic conference held in Moscow and devoted to modern technologies of nutritional support in pediatrics. Modern possibilities of clinical nutrition, diet for a sick child and correct choice of nutritional support depending on the child’s disease are presented.

The analysis of the results endoscopically assisted puncture gastrostomy in children undergoing long-term tube feeding, based on 60 cases of installation gastrostomies. Advantages and disadvantages of the two basic techniques puncture gastrostomy. Explain the approaches to the choice of the operating tactics in patients with altered anatomy in the background of comorbidity. Identified contraindications to the use of this technique.

This article provides an analysis of treatment of 192 patients with piofibrinothorax with bacterial destruction of the lungs. The comparative analysis of various treatments on the criteria: long standing drainage of the pleural cavity, terms of normalization of temperature, the duration of infusion therapy, duration of antibiotic therapy, dynamics of pathological changes in the lung parenchyma and pleural cavity According to X, duration of hospitalization. There were statistically significant differences in all indicators presented in favor of a group of children that apply reorganization thoracoscopic pleural cavity.

The article presents comparative results of endosurgical and traditional surgical approach for bronchiectasis in children. The patients were divided into 2 groups depending on the surgical approach. The control group (1st group) included 26 children who underwent surgery using thoracotomy. 18 patients operated on through thoracoscopy were included in the experimental (2nd) group. Diagnostic stage, thoracoscopic lobectomy and method of treatment of lung root elements were paid an increased focus on. The authors provide a detailed description of endoscopic treatment of bronchiectasis applied in the clinic. The average duration of surgical treatment accounted for 78.3±31 min in the experimental group, duration of pleural drainage is 3.3 days and the average of postoperative hospitalization equals to 14.4±3.4 days. Four observations required conversion in the experimental group. Two patients in the experimental group developed complications such as pneumothorax and bronchial fistula. The pneumothorax was resolved by pleural drainage and the bronchial fistula was managed thoracoscopically. Three patients in the control group developed complications such as bronchial fistulas and pleural empyema in postoperative period. The bronchial fistulas were completed thoracoscopically. The effect was however lacking in one case that’s why rethoracotomy and bronchial closure were performed. The pleural empyema was removed during the recurrent surgery. It has been established that thoracoscopy is the first choice for bronchiectasis in children due to its minimum invasiveness.

The complexity of the treatment of children with destructive forms of pneumonia is largely due to the fact that it is necessary to improve coordination of treatment between pediatricians and surgeons. For 2014 in MDGKB treatment for acute pneumonia received 830 children, with destructive forms over 140, 21 (14%) people had pulmonary and pleural complications, requiring surgical treatment. Coordinated interaction with the surgical service, adequate conservative therapy with regard to etiology, have enabled us to achieve a quick positive dynamics in the patient’s condition.

There were the cases, clinical course, methods of diagnostic and treatment of pus-being eccinoccal desease of lung in children are studied in this work. From 157 cases of surgical ectomia of eccinoccocal cysts in 39 (24,8%) cases there was pus-being eccinoccal cysts and major age of children was from 8 up to 17 years old 84,6%. The major localization was in left lung - 24 (61,5%) patients, in the middle lobe of lung - 13 (33,3%), lower lobe - 22 (56,4%) patients. Open cysts of lung - 53,8%, opening to the bronchi - 35,9%, to the pleural cavity - 17,9%. Methods of diagnostic-X-ray of lungs, U-sound of internal organs and pleural cavity, CT, MRI. Surgical ectomia of eccinoccocal cysts were performed to the all patients. The method of choice to prevent from remaining cavities is step by step sutures with microirrigator. In all patients there were bronchial passes. In the postoperative period there were such difficulties as bronchial passes 2 cases, pleuritis - 3 cases.

More than 1,000 people, including 125 children with severe burns, were suffered in man-made disaster in Bashkiria (1989). The results of the analysis of all stages of care for children were discussed in article. This experience was the basis of becoming a pediatric combustiology in disaster medicine.

The article summarizes the experience obtained in treatment of children with gunshot wounds of the chest both in time of peace and during local armed conflicts and acts of terrorism. Gunshot injuries of the chest in children were characterized by severe damages of organs, frequency of complications (30.9%) and high lethality (25.9%). We analyzed the structure of injuries in the gunshot injury of the chest and in the thoracoabdominal injury and determined indications for thoracotomy. We also developed the therapeutic and diagnostic algorithm which could reduce the number of ‘unnecessary’ thoracotomies and cut the amount of complications.

On February 20, 2015, the founder of pediatric surgery in Tyumen and the Tyumen region, Professor of the Department of Pediatric Surgery, Traumatology and Anesthesiology of the Tyumen State Medical Academy, Doctor of Medical Sciences, Honored Doctor of the Russian Federation Vadim Vasilyevich Ivanov passed away.