Structure of Surgical Intervention at Obliterating Atherosclerosis of Lower Extremities and Aspects of Rehabilitation of Patients with this Pathology
The Relevance of the Topic. In most economically developed countries cardiovascular diseases occupy a leading position among the causes of morbidity, disability, and mortality. Mortality from diseases of the cardiovascular system prevails over mortality from all malignant neoplasms taken together, and, 25% of those who died of cardiovascular diseases are people of working age. Atherosclerosis (aterosclerosis) is a chronic disease, characterized by lipoid infiltration of the inner shell of the arteries of the elastic and mixed types with subsequent development of connective tissue in their wall, and clinically manifested by general and local disorders of blood circulation. Obliterating atherosclerosis is a type of atherosclerosis, characterized by a sharp narrowing or complete closure of the arterial lumen. As a rule, it is observed in the arteries of the lower extremities, heart, kidneys and the external sections of the brain blood vessels. The purpose of the study – to establish the structure of surgical interventions in the obliterating atherosclerosis of the lower extremities and to identify the main aspects that should be addressed for the rehabilitation of patients with this pathology. Methods of research – analysis and synthesis of scientific sources, analysis of medical records. The analysis of 59 medical records of patients after surgical interventions with obliterating atherosclerosis of the lower extremities has been performed. The structure of interventions and their complications for ten months of 2017 have been analysed. The exclusion criterion is patients with obliterative atherosclerosis of the lower extremities with diabetes. Results of the Research. Such patients need rehabilitation interventions, depending on the stage of the disease, on the type of surgical intervention in the early postoperative period and in ambulatory surveillance. Particular attention is needed for patients after amputation of phalanges of toes, the support part foot and amputations above the knee. After all, amputation of the lower extremities significantly disturbs the body’s static, the center of gravity moves toward the retained limb. As a result, the slope of the pelvis, which leads to curvature of the spine and an increase in the load on the retained limb occurs, as well as the atrophy of the muscles of the box. The quality of life of patients significantly decreases. Conclusions. According to the results of the study it has been found out the percentage of women with this disease is lower than that of men, but it is significant, which does not completely coincide with previous studies, and obviously, it is necessary to investigate the causes of the growth of the disease in women. It has been found out that almost a quarter of patients with this diagnosis got into the surgery department at the stage of destructive changes with distinctive ulcers in the distal parts of the limbs and fingers, which led to their amputation.
Mishalov, V. H. & Litvinova, N. Yu. (2006). Khirurhichne likuvannia aterosklerotychnoho okliuziino- stenotychnoho urazhennia brakhiotsefalnykh arterii u khvorykh iz suputnoiu ishemichnoiu khvoroboiu sertsia [Surgical treatment of atherosclerotic occlusion and stenosis of brachiocephal arteries in patients with coexisting ischemic heart disease]. K., Print-Ekspres, 135.
Mishalov, V. H., Nikulnykov, P. I. & etc. (2006). Diahnostyka i likuvannia patsiientiv z khronichnoiu krytychnoiu ishemiieiu nyzhnikh kintsivok, poiednanoiu z multyfokalnym aterosklerozom [Diagnosis and treatment of patients with chronic critical ischemia of the lower extremities, combined with multifocal atherosclerosis]. Ukrayinskyi Konsensus. K., 67.
Chumak, P. Ia., Kuznietsov, A. Ia., Rudyi, M.O. & Kovalov, O. P. (2006). Khirurhichni khvoroby [Surgical pathology]. Ternopil: TDMU, 488.
Cherniak, V. A., Kostromyn, H. A., Uzhanov, O. H. & Koshevskyi, Yu. Y. (2002). Konservativnaia terapiia bolnykh obliteriruiushchim aterosklerozom sosudov nizhnikh konechnostei v sostoianii kriticheskoi ishemii v sochetanii s ishemicheskoi bolezniu serdtsa [Conservative therapy of patients with obliterating vessels atherosclerosis of the lower limb ischemia in combination with coronary heart diseasecritical]. Mizhnarod. simpozium «Hemostaz – problemi ta perspektivy» (5–6 lystopada 2002 r., m. Kyiv). K., no. 31, 342–345.