Diuzhikov A A, Burlakov S G, Dolzhenko N M
Khirurgiia (Mosk). 1989 Mar(3):41-4.
The article analyses the immediate results of preoperative management and treatment of 13 patients with atherosclerosis obliterans of the lower limbs on the basis of drug hypolipidemic therapy and hemosorption on nonspecific sorbents of type CKH. Drug therapy comprised nicotinic acid, its derivatives in a daily dose of up to 2.5 mg, cholestiramine up to 20 g daily, vitamin therapy, and prodectin. Hemosorption was conducted on CKH-2K once in 4 days; 7 patients were given 5 perfusions each, 6 patients--7 perfusions each. Considerable clinical improvement occurred, hemodynamics improved, improvement of lipid metabolism was manifested by decrease of total cholesterol by 22%, triglycerides by 10%, and low density lipoproteins by 43% and increase of high density lipoproteins by 100%. The Cch atherogenicity coefficient decreased by 41%. The expediency of conducting no more than 4 sorptions was revealed and substantiated. Reconstructive vascular operations were performed on the patients. The postoperative period was uneventful. The late-term postoperative period was marked by progressive improvement of rheographic and biochemical values and stable normalization of lipid metabolism.
本文基于药物降脂治疗和使用CKH型非特异性吸附剂进行血液吸附，分析了13例下肢动脉粥样硬化闭塞症患者术前管理和治疗的近期结果。药物治疗包括烟酸及其衍生物，每日剂量高达2.5毫克，消胆胺每日高达20克，维生素治疗和普罗迪菌素。每4天使用CKH - 2K进行一次血液吸附；7例患者每人进行5次灌注，6例患者每人进行7次灌注。出现了显著的临床改善，血流动力学得到改善，脂质代谢改善表现为总胆固醇降低22%，甘油三酯降低10%，低密度脂蛋白降低43%，高密度脂蛋白增加100%。动脉粥样硬化系数降低了41%。揭示并证实了进行不超过4次吸附的合理性。对患者进行了血管重建手术。术后过程顺利。术后后期的特点是血流图和生化指标逐渐改善，脂质代谢稳定正常化。
