Том 331, № 1 (2010)

The article presents whole range of activity of medical service of the Army and Navy. There were defined main directions and peculiarities of medical supply of the Armed Forces in conditions of forming of a new image. A special attention was paid to questions of combat and mobile readiness of medical armed units and institutes taking into account optimization of structure and quantity of medical service of the AF of RF. The main direction of activity of the medical service is organization of treatment-prophylaxis work for saving of life and health of the staff of Army and Navy. The article informs about stabilization of morbidity by the most popular diseases, about capabilities of medical service of armed unit in a new organization-staff structure, about ways of increasing of effectiveness of activeness of military treatment-prophylaxis institutes.

The article presents an overall estimate of experience of surgical treatment of ballistic penetrating wounds of bosom of 1920 wounded in Afgan war (1979-1989) and 367 wounded during the armed conflict on Northern Caucasus (1994-1996). Ballistic penetrating wounds of bosom in modern military conflicts are characterized by high mortality on battle field, achieving 30%. In conditions of heavy wound the choice of optimum surgery tactics poses several difficulties, and due to it indications urgent thoracotomy are often increased. Multistage system of delivery of health care, used in Afgan war, during battle actions on the Northern Caucasus was changed to 2-stage system, where wounded persons during 1-2 hours were delivered to a specialist in multiprofile base hospital, placed in a combat zone. Effectuating of thoracocentesis with a closed drainage of pleural space stays the most popular and extended method of treatment ballistic penetrating wounds of bosom, used by 85% of wounded persons. Using of operative videothoracoscopia in 1995 during delivery of emergency specialized surgical medical care to wounded persons in forward base hospital leaded to decreasing of frequency of using of large thoracotomy to 2,4%. There was overviewed the modern conception of surgical treatment of patients, having bosom wounds.

There was realized a risk-stratification in accord with elaborated evaluative hazard rating of cordial complications during effectuating of transcutaneous coronary operations (TCO) by 109 patients with myocardial infarction without increasing of ST segment on ECG (MIWIST). There were marked 2 groups: group of the 1st and the 2nd stage of risk with using of 2-component (aspirin+klopidogrel) and 3-component (aspirin+klopidogrel+blocker of glycoprotein IIb/IIIa receptors of thrombocytes) ancillary contra-thrombocyte therapy (CTT). Was concluded, that in conditions of effectuating of TCO by patients with MIWIST, relating to the 1st stage of risk of cordial complications in accord with elaborated evaluative hazard rating, 2-component CTT permits achieve 100% of clinical-angiographic effect; there was showed using of 3-component CTT among patients of the 2nd stage of risk.

The article presents not well-known data about genesis, family status and private life of a famous Russian historian of medicine, judicial physician and hygienist of the XIX century Chistovich Yakov Alekseevich. He was the leader of Saint-Petersburg Medical-surgical academy in 1871-1875. There was lighted a civil activity of Chistovich Ya.A. on the post of the chief of Supportive medical cash and chief of Collective of Russian physicians in S.-Petersburg.

The article is devoted to the history of forming and developing of the 7 th Central Policlinic of Strategic Missile Forces, which the 22 nd of January 2010 has it’s 50 th anniversary. The article presents the results of activity of the policlinic in promotion of health of servicemen, work, effectuating by policlinic staff, in a sphere of reclaiming and involving of modern high-informative methods of diagnostics and treatment, there were given main of them.