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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nmp</journal-id><journal-title-group><journal-title xml:lang="ru">Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь»</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Sklifosovsky Journal "Emergency Medical Care"</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2223-9022</issn><issn pub-type="epub">2541-8017</issn><publisher><publisher-name>“N.V. Sklifosovsky Research Institute for Emergency Medicine”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.23934/2223-9022-2019-8-2-132-137</article-id><article-id custom-type="elpub" pub-id-type="custom">nmp-630</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Этапный и симультанный подходы в хирургическом лечении сочетанных поражений каротидного и коронарного русла</article-title><trans-title-group xml:lang="en"><trans-title>Staged and Simultaneous Approaches in the Surgical Treatment of Multisystem Disorders of the Carotid and Coronary Bloodflow</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хаджибаев</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Khadzhibayev</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хаджибаев Абдухаким Муминович - доктор медицинских наук, профессор, заместитель министра здравоохранения Республики Узбекистан, генеральный директор РНЦЭМП.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Abdukhakim M. Khadhzibayev - Dr. Med. Sci., Professor, Deputy Minister of Health of the Republic of Uzbekistan, General Director.</p><p>2 Kichik Xalqa Yo’li, Tashkent 100081</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Обейд</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Obeid</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Обейд Мустафа Абдулрахман - ведущий кардиохирург отделения кардиохирургии РНЦЭМП, Отделение кардиохирургии.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Mustafa A. Obeyd - Leading Cardiac Surgeon of the Department of Cardiac Surgery.</p><p>2 Kichik Xalqa Yo’li, Tashkent 100081</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Акалаев</surname><given-names>Р. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Akatayev</surname><given-names>R. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Акалаев Рустам Нурмухамедович - доктор медицинских наук, профессор, руководитель научно-клинического отдела токсикологии РНЦЭМП, Отделение кардиохирургии.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Rustam N. Akalayev - Dr. Med. Sci., Professor, Head of the Scientific and Clinical Department of Toxicology.</p><p>2 Kichik Xalqa Yo’li, Tashkent 100081</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдурахманов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdurakhmanov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Абдурахманов Абдусалом Абдулагзамович - кандидат медицинских наук, заведующий отделением кардиохирургии РНЦЭМП.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Abdusalom A. Abdurakhmanov - Cand. Med. Sci., Head of Department of Cardiac Surgery Republican Scientific Center of Emergency Medicine Cardiac Surgeon of the Department of Cardiac Surgery.</p></bio><email xlink:type="simple">ab.abdurahmanov@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Машрапов</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Mashrapov</surname><given-names>O. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Машрапов Ойбек Абдугопирович – кардиохирург отделения кардиохирургии РНЦЭМП.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Oybek A. Mashrapov - Cardiac Surgeon of the Department of Cardiac  Surgery.</p><p>2 Kichik Xalqa Yo’li, Tashkent 100081</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдухалимов</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdukhatimov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Абдухалимов Илхом Азамович - кардиохирург отделения кардиохирургии РНЦЭМП.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Ilkhom A. Abdukhalimov - Cardiac Surgeon of the Department of Cardiac           Surgery.</p><p>2 Kichik Xalqa Yo’li, Tashkent 100081</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рахимов</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Rakhimov</surname><given-names>N. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рахимов Нодир Мухторович - кардиохирург отделения кардиохирургии РНЦЭМП.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Nodir M. Rakhimov - Cardiac Surgeon of   the         Department      of Cardiac           Surgery.</p><p>2 Kichik Xalqa Yo’li, Tashkent 100081</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ганиев</surname><given-names>У. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Ganiyev</surname><given-names>U. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ганиев Улугбек Шухратович - кардиохирург отделения кардиохирургии РНЦЭМП.</p><p>100081, Ташкент, ул. Малая кольцевая, д. 2</p></bio><bio xml:lang="en"><p>Ulugbek S. Ganiyev - Cardiologist of the Department of Cardiac Surgery.</p><p>2 Kichik Xalqa Yo’li, Tashkent 100081</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Республиканский научный центр Экстренной Медицинской Помощи<country>Узбекистан</country></aff><aff xml:lang="en">Republican Scientific Center of Emergency Medicine<country>Uzbekistan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>10</day><month>08</month><year>2019</year></pub-date><volume>8</volume><issue>2</issue><fpage>132</fpage><lpage>137</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Хаджибаев А.М., Обейд М.А., Акалаев Р.Н., Абдурахманов А.А., Машрапов О.А., Абдухалимов И.А., Рахимов Н.М., Ганиев У.Ш., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Хаджибаев А.М., Обейд М.А., Акалаев Р.Н., Абдурахманов А.А., Машрапов О.А., Абдухалимов И.А., Рахимов Н.М., Ганиев У.Ш.</copyright-holder><copyright-holder xml:lang="en">Khadzhibayev A.M., Obeid M.A., Akatayev R.N., Abdurakhmanov A.A., Mashrapov O.A., Abdukhatimov I.A., Rakhimov N.M., Ganiyev U.S.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.jnmp.ru/jour/article/view/630">https://www.jnmp.ru/jour/article/view/630</self-uri><abstract><p>Цель исследования материал и методы.Проведение сравнительного анализа непосредственных результатов симультанных и этапных методов реваскуляризации у больных с сочетанным поражением коронарного и каротидного русла.</p><sec><title>Материал и методы</title><p>Материал и методы. В исследование включены 45 больных с сочетанным поражением коронарного и каротидного русла, оперированных в Республиканском научном центре Экстренной Медицинской Помощи в 2014-2018 гг. Больные разделены на две группы: симультанная, 20 больных - проведены симультанные вмешательства на каротидных (КрА) и коронарных артериях (КА), и этапная, 25 больных -стенозы КрА и КА устраняли этапно. Во всех случаях хирургическое вмешательство проводили без искусственного кровообращения.</p></sec><sec><title>Результаты</title><p>Результаты. По результатам работы в послеоперационном периоде в группе симультанных и этапных вмешательств частота неврологических осложнений составила 4,0% vs 5,0%. В группе этапных вмешательств смертельных исходов не произошло, тогда как в группе симультанных вмешательств наблюдался один смертельный исход (5%), связанный с легочными осложнениями.</p></sec><sec><title>Выводы</title><p>Выводы. Доказано, что симультанный и этапный подходы при лечении сочетанного поражения каротидного и коронарного бассейнов не отличались статистически достоверно в отношении церебральных и сердечно-сосудистых исходов.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Aim of study</title><p>Aim of study. A comparative analysis of the early outcomes of simultaneous and staged methods of revascularization in patients with a combined coronary and carotid artery stenosis.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study included 45 patients with combined carotid and coronary artery stenosis, operated at the Republican Research Centre of Emergency Medicine in 2014-2018. Patients were divided into two groups: “simultaneous”, 20 patients (simultaneous interventions on the carotid and coronary arteries were performed) and “staged”, 25 patients (carotid and coronary artery stenoses were operated in a staged manner). In all cases, surgical intervention was performed on the beating heart.</p></sec><sec><title>Results</title><p>Results. According to the results of work in the postoperative period, the incidence of neurological complications in the group of staged interventions and in the group of simultaneous interventions was 4.0% vs 5.0%, respectively. In the group of staged interventions, no deaths were observed, whereas in the group of simultaneous interventions, one lethal outcome was observed (5%) associated with pulmonary complications.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>каротидная эндартерэктомия</kwd><kwd>аортокоронарное шунтирование</kwd><kwd>ишемическая болезнь сердца</kwd><kwd>стеноз каротидных артерий</kwd></kwd-group><kwd-group xml:lang="en"><kwd>carotid endarterectomy</kwd><kwd>coronary artery bypass grafting</kwd><kwd>coronary artery disease</kwd><kwd>stenosis of carotid arteries</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Bacci M.R., Santos J.A. Stroke and myocardial infarction: a terrible association. BMJ Case Rep. 2012 Nov 9; 2012. pii: bcr2012007089. PMID: 23144345. PMCID: PMC4543709. 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