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08634cam a2200481 i 4500 |
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NSK01000186098 |
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HR-ZaNSK |
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20161007140410.0 |
| 008 |
970403s1996 ci a m 000 0 hrv |
| 035 |
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|9 (HR-ZaNSK)186305
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|9 (HR-ZaNSK)970403021
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|a (HR-ZaNSK)000186098
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|a HR-ZaNSK
|b hrv
|c HR-ZaNSK
|e ppiak
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|a hrv
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|a ci
|c hr
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|a 616-089.8-036
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| 100 |
1 |
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|a Bekavac-Bešlin, Miroslav
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| 245 |
1 |
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|a Usporedba koncentracije reaktanata akutne faze u postoperacijskom tijeku kod hitnih i elektivnih kirurških operacijskih zahvata :
|b doktorska disertacija /
|c Miroslav Bekavac Bešlin.
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| 260 |
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|a Zagreb :
|b M. Bekavac Bešlin,
|c 1996
|e ([s. l. :
|f s. n.])
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| 300 |
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|a 95 listova :
|b ilustr., table, graf. prikazi ;
|c 30 cm.
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| 500 |
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|a Doktor biomedicinskih znanosti - medicina.
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| 500 |
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|a mentor: Andrija Georgijević; Komisija za ocjenu: Ahmed Pirkić, Andrija Georgijević, Vanja Zjačić-Rotkvić, Vladimir Stančić; Komisija za obranu: Ahmed Pirkić, Andrija Georgijević, Vanja Zjačić-Rotkvić, Vladimir Stančić; datum obrane: 27.12.1996.; datum promocije: 14.02.1997.
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| 502 |
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|a Sveučilište u Zagrebu, Stomatološki fakultet, Zagreb, 1996
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|a Bibliografija: str. 89-94
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|a Summary
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| 520 |
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|a Sažetak: Provedenim istraživanjem pokušali smo ustanoviti postoji li razlika u reaktivnosti organizma nakon operacijske traume kod bolesnika operiranih zbog akutnih i kroničnih bolesti, ratnih ranjenika i osoba s akcidentalnim mirnodopskim traumama, bolesnika s malignim bolestima, te bolesnika operiranih zbog iste bolesti klasičnom odnosno laparoskopskom tehnikom. Reaktivnost organizma pratili smo mjerenjem koncentracija reaktanata akutne faze (RAF-ova), u krvi i to fibrinogena, [alfa]1 AT-a i [alfa]2 MG-a. Ispitni uzorak činilo je 143 bolesnika, svi operirani u Kliničkoj bolnici Sestara milosrdnica u Zagrebu i Ratnoj bolnici Velika Gorica u istoimenom mjestu.
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| 520 |
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|a Ispitanike smo svrstali u 12 skupina (1. ranjeni borci HV-a, 2. osobe s akcidentalnom traumom, 3. bolesnici s benignim bolestima kralježnice, 4. bolesnici s akutnim moždanim krvarenjima, 5. bolesnici s akutnim abdominalnim bolestima, 6. bolesnici s kroničnim abdominalnim bolestima, 7. bolesnici s kroničnim abdominalnim bolestima operirani laparoskopskom metodom, 8. bolesnici s malignim bolestima abdomena, 9. bolesnici s tumorom mozga, 10. bolesnice s karcinomom dojke, 11. bolesnici s benignim urološkim bolestima, 12. bolesnici s malignim urološkim bolestima), te svakom od njih odredili koncentraciju analiziranih reaktanata u krvi, prvog, trećeg i osmog postoperacijskog dana.
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| 520 |
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|a Na temelju dobivenih rezultata možemo zaključiti da bolesnici s kroničnim upalnim bolestima imaju značajno nižu sekreciju fibrinogena i [alfa]1 AT-a od bolesnika operiranih zbog akutnih upalnih bolesti. Uspoređujući manje skupine, ustanovili smo da razlike između njih nisu bile toliko jasne, jer interindividualna razlika u reaktivnosti na akutni i protrahirani stres kod manjeg broja ispitanika dolazi više do izražaja. Ranjeni borci HV-a imali su nižu koncentraciju fibrinogena, [alfa]1 AT-a i [alfa]2 MG-a od ispitanika stradalih od mirnodobske akcidentalne traume. To tumačimo slabijim odgovorom organizma na ranjavanje nakon protrahiranog stresa (dugotrajan boravak na bojišnici).
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| 520 |
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|a Tumorske bolesti, posebice urološke, prati značajno povišenje koncentracije [alfa]1 AT-a i sniženje koncentracije [alfa]2 MG-a, vjerojatno zbog veće potrošnje [alfa]2 MG-a u inhibiciji serumskih proteaza. Laparoskopska operacijska tehnika minimalno aktivira makrofagni sustav i bitno je manji podražaj organizma i sekrecija RAF-a. Različite lokalizacije tumora daju različit odgovor na operacijski stres, pa tako bolesnici s tumorom mozga i bolesnice s rakom dojke imaju značajno nižu reaktivnost od ispitanika s tumorima abdomena i malignim urološkim bolestima. Smatramo da dobiveni rezultati ukazuju na moguću korist perioperacijskog uvođenja terapije antioksidansima kod bolesnika s kroničnim i malignim bolestima. Neophodno je posvetiti pozornost prevenciji tromboembolijskih i hemoragijskih komplikacija pri operacijskim zahvatima.
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| 520 |
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|a Manja mutilacija tkiva i minuciozna operacijska tehnika imaju slabiji stresni odgovor u perioperacijskom vremenu. To govori u prilog uvođenja laparoskopske tehnike pri operacijskim zahvatima s dostupnim lokalizacijama patološkog supstrata uz obavezno uvažavanje kirurških onkoloških principa.
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| 520 |
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|a Summary: Through research we tried to determine whether there is a difference in reaction of the organism after the surgical trauma with patients operated because of acute and chronical diseases, people wounded in war and people with accidental traumas that were not caused by war, patients that had malignant diseases, patients operated on the same disease by using the classical, or laparoscopic technique. The reaction of the organism was surveyed by measuring the concentration of the reactants of the acute phase (RAF) in blood, i.e., fibrinogene, [alfa]1 AT and [alfa]2 MG. The examined sample was 143 patients, all of them operated in the Clinical Hospital "Sestre milosrdnice" in Zagreb and in the War hospital in Velika Gorica.
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| 520 |
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|a We classified them into 12 groups (1. wounded soldiers of the Croatian Army, 2. people with accidental trauma, 3. people with benign diseases of the spine, 4. patients with acute brain hemorrhages, 5. patients with acute abdominal diseases, 6. patients with chronical abdominal diseases, 7. patients with chronical abdominal diseases operated by laparoscopic technique, 8. patients with malignant diseases of the abdomen, 9. patients with brain tumors, 10. patients that had breast carcinoma, 11. patients with benign urological diseases, 12. patients with malignant urological diseases), and for each of them we determined the concentration of the analyzed reactants in blood, on the first, third and eight post-operative day.
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| 520 |
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|a Based on the results that were achieved, we can conclude that patients with chronical inflammatory diseases have a significant lower secretion of fibrinogen and [alfa]1 AT, than the patients that were operated because of acute inflammatory diseases. By comparing smaller groups, we found out that the differences between them were not so visible, because interindividual differences in reactivity of the acute and prolonged stress are more visible in smaller groups of examined patients. The wounded soldiers had a lower concentration of fibrinogen, [alfa]1 AT and [alfa]2 MG, than the patients that were wounded in accidental trauma in everyday life. We explain this with weaker reaction of the organism after wounding, after prolonged stress (long-time presence in the battlefield).
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| 520 |
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|a Tumor diseases, especially urological, are followed by prominent increase of the concentration of [alfa]1 AT and the decrease of the [alfa]2 MG concentration, probably because of a higher consumption of [alfa]2 MG in the inhibition of the serum protheasis. The laparoscopic surgical technique is minimally activating the macrophagical system, and there is less stimulation of the organism and the secretion of RAF. Different localisations of tumors give different responds to operational stress, so that patients with brain tumors and patients with breast cancer have importantly lower reactivity than patients with abdominal tumors and those with malignant urological diseases.
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| 520 |
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|a We consider that the results that were achieved, show a possible benefit of the perioperational implementation of therapy using antioxidants for patients with chronical and malignant diseases. It is an imperative to pay attention to prevention of the thromboembolism and haemorrhagical complications during the surgical procedures. A smaller mutilation of the tissue and meticulous surgical technique achieve lower stress reactions in peroperational time. This speaks in favor of the implementation of the laparoscopic technique in the surgical procedures, with accessible localizations of the pathological substrate with obligatory respecting the surgical oncological principles.
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| 650 |
|
7 |
|a Proteini akutne faze upale
|v Disertacije
|2 nskps
|
| 650 |
|
7 |
|a Kirurgija
|x Fiziološki aspekti
|v Disertacije
|2 nskps
|
| 700 |
1 |
|
|a Georgijević, Andrija
|4 cns
|
| 981 |
|
|
|p CRO
|r HRB1996
|
| 998 |
|
|
|n DCD
|c sbn, 199704
|c rjkp9803
|c astp161007
|c ktup161007
|
| 852 |
4 |
|
|j DCD-ZG-44/97
|
| 876 |
|
|
|e DCD
|a 44/1997
|
| 886 |
0 |
|
|2 unimarc
|b 08259iam0 2200397 450
|