[Preoperative preparation of patients with arteriosclerosis obliterans]

The article analyses the immediate results of preoperative management and treatment of 13 patients with atherosclerosis obliterans of the lower limbs on the basis of drug hypolipidemic therapy and hemosorption on nonspecific sorbents of type CKH. Drug therapy comprised nicotinic acid, its derivatives in a daily dose of up to 2.5 mg, cholestiramine up to 20 g daily, vitamin therapy, and prodectin. Hemosorption was conducted on CKH-2K once in 4 days; 7 patients were given 5 perfusions each, 6 patients--7 perfusions each. Considerable clinical improvement occurred, hemodynamics improved, improvement of lipid metabolism was manifested by decrease of total cholesterol by 22%, triglycerides by 10%, and low density lipoproteins by 43% and increase of high density lipoproteins by 100%. The Cch atherogenicity coefficient decreased by 41%. The expediency of conducting no more than 4 sorptions was revealed and substantiated. Reconstructive vascular operations were performed on the patients. The postoperative period was uneventful. The late-term postoperative period was marked by progressive improvement of rheographic and biochemical values and stable normalization of lipid metabolism.