THE RELATIONSHIP OF MORPHO-FUNCTIONAL PARAMETERS OF PERIPHERAL BLOOD AND HEMOMICROCIRCULATORY BED OF SOFT TISSUES WITH TREATMENT TACTICS IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES

Abstract

Purpose: study of the correlation of blood cells (BC), hemomicrocirculatory bed and neoangiogenesis with various treatment options in the perioperative period of indirect revascularization in patients with critical ischemia of the lower extremities. Material and methods: Morphological analysis of peripheral blood was performed in 162, and morphological analysis of the hemomicrocirculatory bed of soft tissues - in 80 patients. The nature of the relationships between nonparametric indicators was clarified by calculating the correlation coefficient (r) and the Pearson criterion (χ2) at a confidence probability level of P = 0.95 (p<0.05).
Results: Varying degrees of improvement in the metabolic parameters of BC after treatment was found in 101 (62.3%) of 162 patients. Normalization of the index of oxygen saturation of erythrocytes was noted only in 3 patients, although the positive dynamics of this indicator was observed in 86 patients (53.1%). Of the 80 analyzed patients in 40 (50.0%)
with clinically, laboratory and morphologically positive dynamics in soft tissues, neoangiogenesis of varying degrees of intensity was revealed. In 34 of these 80 patients (42.5%) at the end of treatment, an increase in the total density of vessels was also noted. According to the results studied, complex and ambiguous links were established between neoangiogenesis, the morpho-functional state of the microcirculatory bed in soft tissues, as well as metabolic and functional parameters of BC and therapeutic tactics in the perioperative period of indirect revascularization in patientswith critical ischemia of the lower extremities.
Conclusion: The best results were obtained in patients treated with a combination of revascularizing osteotrepanation with bone marrow and intravenous laser irradiation and cytokine therapy.