Gepato-gastroeterologik tadqiqotlar jurnali 2022, №3
Subject of the article
O‘PKA VA JIGAR QO‘SHMA EXINOKOKKOZIDA JARROHLIK TAKTIKASI (20-25)
Authors
Murtazaev Z. I.; Baysariev Sh. U.
Institution
Samarqand davlat tibbiyot universiteti
Abstract
Dolzarbligi. O‘pka va jigar exinokokkozi davosida xirurgik usul hozirgacha asosiy bo‘lib qolmoqda. Muqobil konservativ davo esa uncha samarali emas. Ushbu tadqiqotimizning asosiy maqsadi exinokokkozning o‘pka va jigar kistalarini davolashda minimal invaziv xirurgik aralashuvlarni baholashdan iborat. Material va metodlar. Ushbu ishimiz Samarqand Davlat tibbiyot universitetining umumiy xirurgiya kafedrasi klinikasida o‘pka va jigarning qo‘shma exinokokkoziga chalingan 112 nafar bemorni xirurgik yo‘l bilan davolash natijalarini o‘z ichiga oladi. Klinik material uch guruhga bo‘lingan: birinchi guruhda (nazorat guruxi) 36 (32,14%) bemor bo‘lib, o‘pka va jigardagi kistalar alohida keng kesmalar orqali operatsiya qilingan. Shu qatorda, 34 (94,44%) bemorda o‘tkazilgan operatsiyalar 4-6 haftalik interval bilan etapma-etap amalga oshirildi, 2 (5,56%) nafar bemorda esa, exinokokkektomiya amaliyoti bir momentli, ya’ni o‘pka va jigardan bir vaqtning o‘zida alohida kesmalar orqali amalga oshirildi; Ikkinchi guruhdagi 29 nafar (25,89%) bemorga bir vaqtning o‘zida torakofrenolaparotomiya yo‘li bilan o‘ng o‘pka va jigardan exinokokk kistalari olib tashlandi; Uchinchi guruhdagi 47 (41,97%) bemorda o‘pka va jigardagi kistalarni olib tashlash bosqichma-bosqich amalga oshirildi. Shundan 35 (74,47%) holatda, exinokokkektomiyaning ma’lum bosqichlarida o‘zimiz tomondan ishlab chiqilgan videoassistentlashtirilgan minikesimlardan foydalandik, va 12 (25,53%) holatda - barcha torakal va qorin bo‘shlig‘iga kirishlar faqat mini-kesmalar yordamida amalga oshirildi. 7 nafar bemorda o‘pka va jigardagi kistalar uchun bir vaqtning o‘zida bir momentli alohida mini-kirish orqali xirurgik aralashuvlar amalga oshirildi, 5 nafar bemorda esa to‘rt haftalik interval bilan bosqichma-bosqich o‘pka va jigardan kistalar olib tashlandi. Minimal invaziv yondashuvlar va bir vaqtning o‘zida bajarilgan operatsiyalarni qo‘llash operatsiyadan keyingi erta asoratlarni 13,89% dan (nazorat guruhi) 9,21% gacha, (asosiy guruh) ya’ni deyarli 2 marta kamaytirishga yordam berdi. Xulosa: ushbu tadqiqotimiz shuni ko‘rsatdiki, endovizual texnologiyadan foydalanish o‘pkada va jigar kistalarining qo‘shma lokalizatsiyasida ham minimal invaziv kirish orqali operatsiyalarni o‘tkazishga imkon beradi va an’anaviy torakotomiya va laparotomiya usullari bilan bajarilgan operatsiyalarga nisbatan operatsiyadan keyingi asoratlar sonining ko‘payishiga olib kelmaydi.
Key words
jigar exinokokkozi, o‘pka exinokokkozi, qo‘shma exinokokkoz, laparoskopik exinokokktomiya, minilaparotom exinokokktomiya, laparotom exinokokktomiya.
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