STIMULATION OF REGIONAL BLOOD FLOW BY REVASCULARIZING OSTEOTREPANATION OPERATION WITH INTRAOSSEOUS LASER IRRADIATION IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES

Abstract

The results were conducted to study the features of stimulation of regional blood flow by revascularizing osteotrepanation surgery with intraosseous laser irradiation in patients with critical ischemia of the lower extremities (CILE). Studies were conducted in 79 patients with (CILE). 48 patients underwent generally accepted conservative and surgical treatment (control group). In 31 patients, stimulation of regional blood flow was carried out by revascularizing ostesttrepanation with intraosseous laser irradiation (ROT with IOLI) (the main group). The following parameters of regional arterial and venous blood flow were studied: regional systolic pressure (RSP) standing and lying down, gradient of regional systolic pressure (RSPQ), postocclusive venous pressure (POVP) standing and lying down, gradient of postocclusive venous pressure (POVPQ), venous-arterial index (VAI) standing and lying down. These parameters were compared with similar indicators of 48 practically healthy individuals (reference group). Statistical processing of the obtained data was carried out. The study showed that in the control group at the end of inpatient treatment, there was a tendency to stimulation. 3-4 months after discharge from the hospital, blood flow stimulation was also unreliable (except for RSP: t = 1.98; p<0,05). In the main group, there was a significant increase in RSP standing and lying down (t = 2,20; p<0,05 and t = 3,52; p<0,01), lying POVP (t =2,03; p<0,05), a significant decrease in VAI standing and lying down, POVP (respectively t = 3,76; p<0,001; t = 2,28; p<0,05 and t = 2,56; p<0,05). 3-4 months after discharge from the hospital, the stimulation of regional blood flow continued reliably. A reliable dependence of blood flow stimulation on ROT with IOLI was also revealed (p<0,001; r= 0,5-0,6). According to the authors, if it is impossible to perform direct revascularization to stimulate regional blood flow, the use of MOUTH with VCLos is pathogenetically justified.