Sklifosovsky Institute: from the house of charity to modern medicine. History Squil

11.04.2019

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Moscow is one of the largest and most expensive cities in the world. Tourists from other countries are constantly coming to the capital. The flow of people from the villages is also huge, since Moscow has long been considered a place where all his plans can be implemented. In connection with the size of the capital, it is impossible to even imagine how many different medical institutions there. One of them is the well-known Sklifosovsky Hospital, the fame of which is distributed far beyond Russia.

The history of the development of the Research Institute

The famous medical institution was formed in the 19th century, then it was called the stable house. He was founded by the Count Sheremetyev to assist the orphans and the patients, for which there was no one to care for. During it became a hospital in which soldiers were served. In 1929, the institution was renamed the ambulance institute named after Sklifosovsky. Experts provided assistance to all those in need of Moscow residents, as well as active scientific activities. From the very beginning of the work, the hospital had a surgical profile, as well as one of their most sought-after branches of traumatology. In the 90s of the last century was expanded. From this time, new branches involved in transplantology, plastic, micro and cardiac surgery began to open.

Activities in our day

Currently, Sklifosovsky Hospital meets all the parameters of the modern medical institution. It is one of the leading medical institutions not only in the capital, but in the whole country. Sklifosovsky Hospital specializes in two large directions. In the walls of a medical institution, both scientific and therapeutic activities are conducted. Thanks to modern equipment and highly qualified specialists, patients from other hospitals of the city and nearby regions are received in the hospital. Per long years Millions of lives were saved to emergency work in the Research Institute of Emergency Research. The building of the Sklifosovsky Research Institute (Hospital), whose address is known almost every resident of Moscow, is located on d. 3. It can be reached by subway or on foot from the Peace Avenue.

Scientific work NII

As you know, continuous research is underway in the medical facility. They are divided into five main directions, among which are the following:

1. Mechanical and thermal injuries.

2. Diagnostics and treatment of acute coronary and cerebral deficiency.

3. The pathology of the abdominal bodies.

4. Treatment of end and exotoxicosis.

5. Organization emergency and in hospital conditions.

A remarkable specialists work on the basis of the Research Institute, many of them have the titles of professors, doctors and candidates of medical sciences. Sklifosovsky Hospital can be proud of its employees.

Medical activities

In the walls of the hospital, it turns out to be urgent and planned surgical assistance in almost all directions. Resuscitation branches are among the most high-tech in the city. Neurosurgery and traumatologists and traumatologists can boast greater successes. Emergency departments are equipped the latest equipmentThey produce complex operations, among which there are many strength interventions. In addition, all conditions for recovery after heavy surgical procedures have been created in the hospital, and there is also own diagnostic complex. Functions own branch of blood transfusion.

One of the leading medical centers of the city is considered to be the Sklifosovsky Hospital. Moscow thanks to this institution is famous for its achievements in the medical sphere.

Stranklynaya House, Institute for Ambulance. N.V. Sklifosovsky

It is with this house that the birth of a Moscow expression is connected - "live on the Sheremetev account." And it means not just to live for someone else's account, but to live and be sure that there is a place where you will always help you.

Schemetez Sheremetyeva Starreek Schemeteyev's stimple house - one of the best Moscow monuments of the era of classicism. Its unusual layout in the form of a horseshoe, a white-eyed colonnade and the original fence is remembered at a glance.

Count Nikolai Petrovich Sheremetev entered Russian history not just as a great theater figure, but also the creator of a stony house. And the fascination of the theater, and the construction of a strange house united the name of the beloved Graph of Women - Praskovy Ivanovna Pearlovy (Kovaleva). She was a fortest actress of his theater.

In 1798, he gave the pearl free, and in November 1801 they secretly married in Moscow. But a young, diversified educated woman, talented singer And the actress was incurably sick tuberculosis. On February 23, 1803, she died, leaving a three-week son on her husband's hands.

Even before the death of his wife, Nikolai Petrovich Sheremetev decided to establish a strange house. He wanted to create a completely unique one - on a peddral background of Russian charitable institutions and societies.

Stranklynaya House, now the Moscow City Research Institute for ambulance. N.V. Sklifosovsky

The complex was conceived by Nikolai Petrovich Sheremetev as a free delicacy and hospital for a hundred people. Designed the institution Architect Elave Semenovich Nazarov. ELGAZY Semenovich applied the usual plan of the urban estate of that time - separated from the street main building With wings, behind the house - park and garden. His idea was distinguished by simplicity and practicality: two wings, two floors for patients and basements for service personnel.

In 1803, after the death of his wife, the Graph decided to devote the building of her memory. For processing the project of a semi-armed house, he invited the brilliant metropolitan architect, an outstanding representative of the Russian classicism of Jacomo Kurengy. The kreparenga knew Praskov's Pearls well and was a fan of her talent.

Under his brilliant pencil, there was a wonderful creation - a high white colonnade, confident of the span of palace wings.

Instead of a modest portist with twisted columns at the entrance, the Kurengy moved forward to a third of the yard a double semicircle of a magnificent open colonnade - Polurotond. She wore a purely decorative purpose.

The kievings also designed four flaghels: Sukharevsky, Spassky, chief caretaker and doctoral.

Completed by 1807 the ensemble of a stable house was recognized by the work of two architects - the Russian chief of Semenovich Nazarov and the Italian Jacomo Antonio Domenico Rosengi. They showered here an example of creative and fruitful cooperation.

According to the project, the interior of the church received a bypass gallery. Painting in the interior of the temple was performed by the artist Domenico Scotty.

It is believed that the composition "Triipostasic Divine in Glory" composition has a special expressiveness. In the lower part of the composition, the latin is preserved today: "Domen's Scotty is invented and depicted with paints in 1805." According to legend, the face of one of the cherubs (with a palm branch) was written Scotty from the young graph Dmitry Nikolayevich Sheremeteva. And in the features of an angel with a bubble, a portrait image of Praskovia Ivanovna Sheremeteva is read.

Two majestic burners on the side walls of the temple "Resurrection of Lazarus" and "bearer" by the king of ryod of babies "were performed by Academician of Sculpture by Gabriel Tikhonovich Zamarayev.

The solemn opening of a stimple house took place a year and a half after the death of the founder - June 28, 1810. The celebration was timed to the birthday of Nikolai Petrovich Sheremetyev.

The stimping house was designed for a hundred fifty people: the Laddle (left wing of the building) for a hundred students (fifty men and women) and the hospital in the right wing at fifty patients. The wing wing of the house ended with the majestic twisting dining room.

Muscovites immediately called this house Sheremetevsky. And not in vain. Nikolai Petrovich put a huge capital for the content - 500 thousand rubles. In addition, he won her "In Eternity", the village of Young Tud with villages in the Tver province - eight thousand souls. Of the tools, it was necessary to feed and enslave the warrant, helping families who fell into trouble, to give a dowry to poor brides, "the poor and orphaned maiden". The dowry was awarded annually on February 23, on the anniversary of the death of the Countess Praskovia Ivanovna.

The beneficiaries of the house were not limited to the walls of the Laddle and Hospital. The annual sums were released on "to the auxiliary families of any condition undergoing poverty, to help impoverish artisans, deposits in the temples, to create a library with a reading room, on the burial of the poor and other needs. More than two hundred thousand people received help here. Then the expression was born - "live on the Sheremetyevsk account."

Hospital of a strange house, later called Sheremetyevskaya, played a prominent role not only in the provision medical care The poorest residents of Moscow, but also in the organization of a higher medical education system. The activities of prominent domestic physicians were connected with the Sheremetevsk hospital. Much survived this amazing house - wars and revolutions, terrible epidemics. In the Sheremetev hospital were treated by the wounded - the heroes of 1812, battles on the chips and the piers, the defenders of Port Arthur and the First World War.

The Moscow Guide of 1896 indicated this house as "Streaklynaya House of Circa Sheremetev at Sukharevskaya Sadovaya."

In 1918, the name of the stable house was eliminated. The church was closed, and the charity institution turned into an ordinary hospital. In 1919, the Moscow City Ambulance station was organized here.

In 1923, the Sheremetev hospital was transformed into ambulance. N.V. Sklifosovsky and she was given all the building at home. Interestingly, Nikolai Vasilyevich Sklifosovsky never was never in a strange house. But it is believed that the name of the Great Surgeon appeared on the hospital sign not by chance. After all, he devoted a majority of his life to charity and people, a few wars passed, wrote a lot of scientific papers. In his office hung an inscription: "The burden itself, Sveti others."

A comprehensive restoration of the ensemble of a strange house began in 1986. And since that time in the building opened Central Museum Medicine, transformed in 1991 to the Medical Museum Research Center. The Russian House of Mercy is located here.

And the self ambulance them. N.V. Sklifosovsky today has become the largest multidisciplinary scientific and practical center for emergency medical care in Russia.

Motto noble rhodation Sheremetev said "God saves everything." Two extreme centuries of the existence of an amazing house on Sukharevskaya Square accurately confirmation.

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Research Institute of Ambulance named after N. V. Sklifosovsky He leads his story from a stable house based on charitable objectives by Count Nikolai Petrovich Sheremetev in 1803 and officially open in 1810. The house consisted of a hospital on 50 "suffering from ailments" and shelter for 25 girls-orphans. It was one of the first institutions in Russia to provide medical care to the poorest segments of the population.

History

During the Patriotic War of 1812, a hospital was first located in the building of a stainless house, then the Russian army, and later the hospital for the wounded in the Russian-Turkish war of 1878. The wounded from the fronts of the Russian-Japanese and First World War came here. Permanent surgical practice was carried out here since 1815. In 1923, on the basis of the Sheremetyevsk hospital (formerly stable house), an emergency institute, which has been named after N. V. Sklifosovsky and well-known Muscovites and residents of other cities of Russia as a medical institution, providing highly qualified assistance at any time and to any patient has been organized. .

At the Rights of the Department, the Institute was attached to the ambulance station located on its territory, which was led by the head physician of the Sheremetev Hospital G. M. Gerstein. In the same 1923, the ambulance station was headed by A. S. Puchkov. Under his leadership, organizational principles were developed, a system of documentation and reporting was created, a technical re-equipment was carried out, as a result of which the station was published on a new qualitative level. The station remained as part of the Institute until 1940, and then was allocated to an independent organization.

The Collective of the Institute One of the first in the country has begun to develop and practical construction state system providing emergency medical care for acute diseases and injuries. The institute was the first to raise the issue of the need for preventive work to prevent accidents and contributed to the adoption of a number of measures, secured various parties to the life of the population of Moscow.

The institute was also a pioneer in creating an emergency surgical service. Its basic principles are formulated and developed here: qualified operational assistance at any time, uniformity of tactics and techniques of operations, participation in the diagnosis of radiopologists and staff of the clinical laboratory, the practice of morning conferences to discuss the outcome of the work for the past day.

During the Great Patriotic War, the Research Institute. N. V. Sklifosovsky accepted tens of thousands of wounded. Here were the most complex operations to save the lives of fighters and returning them into operation. Many surgeons, nurses and sanitary cars worked at the front. At the end of the war, the surgical and therapeutic services of the institute were reorganized and summarized with the tasks of peacetime.

Pre-war and military periods of the Institute are noted by major scientific achievements in the field of medicine. Works of outstanding scientists V. A. Krasinseva (1866-1928), A. S. Puchkov, Academicians of AMN S. S. Yudina, B. A. Petrov (1898-1973), A. N. Kryukova, Corresponding Member of AMN D . A. Arapova, Professors P. I. Androsov, B. S. Rozanova (1896-1979), A. V. Rusakov and other prominent specialists of the institute were laid out the foundations of the theory and practice of emergency medical care as a special health industry. The principles of emergency surgical assistance developed by the Cornels remain in force and at present, which convincingly testifies to their correctness.

The development of medical science contributed to the creation at the Institute of the Dissertation Council to protect candidate dissertations in the field of surgery, traumatology and orthopedics, anesthesiology and resuscitation. In 1978, during the Presidium of the AMN of the USSR, the Scientific Council on emergency medical care issues created for planning, coordinating and managing research in this area was formed. The headquarters were defined by the ambulance. N. V. Sklifosovsky, who began to exercise a single scientific research work on the basis of the city and the country. The need to open multidisciplinary hospitals in the country of multidisciplinary hospitals was scientifically substantiated. Due to the emergence of almost two hundred such hospitals and the creation of specialized ambulance brigades (cardiological, toxicological, resuscitation, etc.), the quality of urgent state treatment has improved significantly.

Introduction to operation in 1982 the clinical and surgical corps with 15 well-equipped operational contributed to further development Emergency surgery, as well as neurosurgery and traumatology. As a result, the institute became the leading center of emergency surgery not only in Moscow, but also in the country.

In the period 1992-2006 There were significant changes in the research institutes caused by the requirements of modern medical science. Created branches of acute endotoxicosis, liver transplantation, emergency plastic and reconstructive microsurgery, laboratory of new surgical technologies, emergency cardiac surgery department and urban burn center. The hulls are reconstructed, where the separation of acute thermal lesions (urban burn center) and acute poisoning (urban toxicological center) are located, the liver transplantation and separation of crisis and psychosomatic disorders. A new building was built for an emergency cardiac surgery. The restoration of the first corps of the old building of the institute is completed - the monument of architecture of the beginning of the XIX century. Here will again open the Museum of Surgery and the History of the Institute, established in 1948 on the initiative of Academician S. S. Yudina. Refailed a number of others historic buildings, including a chapel. A vintage park is maintained in exemplary manner, which is an integral part of a kind of institutional ensemble.

In order to significantly accelerate and improve the quality of the medical and diagnostic process and improving the working conditions of personnel in recent years, the reconstruction of the reception office, the operating unit, a number of resuscitation departments, a complex of laboratory and tools and diagnostic units and the disinfection block was carried out.

The activities of the Institute

Today, N. V. Sklifosovsky emergency care is the largest multidisciplinary scientific-practical emergency medical center in Russia. All its units provide free 24-hour highly qualified medical care to everyone who appeals. Tasks of the Institute - scientific activity, medical care for patients and affected, training and advising specialists in emergency medicine.

The Institute has formed over 40 scientific units, more than half of whom are clinical. The large scientific and practical potential of personnel composition, modern equipment allow you to successfully develop new and improve existing methods diagnosis and treatment of the most severe damage and complicated acute surgical diseases. At the Institute work more than 800 researchers and doctors, including 2 academicians and 2 corresponding member of the RAMS, 37 professors, 78 doctors and 167 candidates of medical sciences. There are 918 inpatient beds, including 90 resuscitation. During the year, more than 20 thousand different operations are carried out on the basis of the institution.

Scientific research is conducted in five main areas: diagnosis and treatment of mechanical and thermal injuries; diagnosis and treatment of acute diseases and damage to the blood vessels, brain, aorta and its branches; diagnosis and treatment of acute surgical diseases of the abdominal organs; diagnosis and treatment of acute exo- and endotoxicosis; Organization at the stationary stage of specialized emergency care for patients and victims.

Over the past 10 years, about 235 case studies have been completed, aimed at improving the quality of diagnosis and treatment. 62 monographs were published, about 4,100 scientific articles and other publications, including 86 job collections. The institute's employees also written a large number of chapters and sections in books issued by other institutions. 43 patents and testimonies for inventions were obtained, passed to the use of 32 racks. 140 dissertations are protected, including 25 doctoral. The introduction of scientific research results in the practice has a positive effect on improving therapeutic work.

The rise in the level of scientific research has led in 2001 to the creation of the dissertation council on the protection of doctoral dissertations in the field of surgery, anesthesiology and resuscitation, traumatology and neurosurgery.

To enhance the professional level of doctors, more than 100 scientific and practical conferences and seminars were held, more than 130 information and methodological documents were published.

The problematic commissions of the Scientific Council on emergency care in the field of combined injury, cardiology and clinical toxicology and the problematic commission on urgent surgery are played in solving scientific and practical problems in the coordination of scientific research on the territory of the Russian Federation. Research results are analyzed in the external department. scientific connections. This significantly accelerates the introduction of advanced achievements of medical science.

Many employees of the institute were awarded state premiums, government premiums and Moscow City Hall. 8 employees were awarded the honorary title "Honored Scientist of the Russian Federation", and 32 - honorary titles "Honored Doctor of the Russian Federation" and "Honored Health Worker of the Russian Federation."

Medical work

The Institute provides free emergency medical care to wide masses of the population. Over the past 10 years, more than 450 thousand patients received it. Only in 2005, therapeutic assistance was provided by 48,895 patients, 24 186 of which were hospitalized (the main channel of revenues - ambulance); There are about 20,700 operations. At the same time, mortality was the smallest in recent years - 4.5%. In 62% of hospitalized (about 15 thousand patients), various types of injury were diagnosed, including mechanical, thermal and chemical. NII named after N. V. Sklifosovsky has the opportunity to provide specialized assistance, which is often unavailable in other medical institutions. For this reason, only in one year 1074 patients were translated into the institute from the hospitals of Moscow, the Moscow region and other regions of Russia. In addition, Moscow's hospitals provide advisory and specialized assistance experts of exit brigades on neurosurgery, endoscopy and endotoxicosis.

Resuscitation at critical states

The Institute has created the most powerful resuscitation service in Russia, consisting of 9 resuscitation branches. During the year, more than 8,500 patients with crank and brain and combined trauma, burns, acute poisoning, heart diseases, vessels, kidneys, liver, and gastrointestinal tract are intensive intensive therapy. The special department is treated with severe clinical laboratory manifestations of endotoxicosis, developing due to polyorgan deficiency. Due to the good equipment of the Institute and High Qualifications of Personnel, mortality in crank-brain injury, vascular diseases of the brain, extensive burns, acute poisoning is the lowest in Russia and corresponds to the international level. Scientific studies allow the Institute to develop recommendations for other emergency medicine institutions. This concerns the introduction of a number of unique technologies - emergency multicomponent detoxification systems, neuromonitoring, hyperbaric oxygenation with the possibility of respiratory prosthetics, healing methods in emergency surgery, etc.

Injury

The causes of mechanical damage are most often road injury, drops from high height, as well as firearms and crushing wounds. The most numerous - patients with mechanical injury (only in 2005 there were 8672). The most severe contingent - patients with a combined, combined injury, whose share was about 35%. For the treatment of such patients, the anti-shock costume "Kashtan" was developed and implemented in industrial production ( gold medal Brussels exhibition 1996). Its use in the prehospital stage made it three times to reduce the frequency of fatal outcomes associated with the development of severe shape of the shock. Submersible osteosynthesis were also introduced with severe fractures and tears of pelvis joints and blocking osteosynthesis in the case of "large" fractures with multiple injury - in recent years, more than 800 such operations have been produced. A system of diagnosis, prevention and treatment of hazardous complications has been developed, which allowed to reduce their frequency of 2-4 times. Thanks to the introduction of scientific developments, mortality in combined injury has been reduced in recent years from 29 to 18% - more than 1.5 times. In addition, endoprosthesising of the hip joint, osteosynthesis cannulated screws, osteosynthesis, and endoprosthetics of crushed ligaments of the knee joint during ruptures, was introduced as early operational treatment of damage.

For 2005, in the peace of ambulance. N. V. Sklifosovsky received 800 victims of the injury of the chest and neck and 230 - with injury or diseases of the esophagus (respectively, 135 and 95). In a large part of cases (more than 160), combined wounds of breast and abdomen were sided, which belong to the most severe types of open injury, as often accompanied by damage to many internal organs and massive blood loss. For such cases, video photocopy is actively used in the emergency toracoabdomominal surgery, with which you can quickly establish the nature of damage to the chest organs and perform the necessary operational interventions, which often eliminates the need for extensive operations and makes it much more accurate to plan the therapeutic process. In addition, the department holds unique interventions, which are performed only at the Institute: Surgical treatment of injuries and damage to the esophagus and the consequences of its chemical and mechanical injury, as well as urgent and reconstructive rehabilitation operations in mechanical damage to tracheas and their consequences (tracheal stricture ). Big successes were achieved in the field of immunoprophylaxis and immunotherapy of purulent and septic complications in victims with penetrating injuries of the chest and abdomen. A technique for the treatment of rolled hemotorax, which allows to reduce the number of traumatic thoracotomy. The undoubted achievement of the Institute is to reduce mortality during injury from 5.7% in 2002 to 3.7% in 2005.

Thermal injury

In 2005, 1740 patients with burns were obtained in the separation of acute thermal lesions. One of the most effective methods The treatment of burning injury is an early active surgery (removal of non-visual fabrics, skin transplantation), due to which it is possible to save victims, even relatively recently considered doomed. Other methods are developed to improve the quality of treatment: cell therapy, comprehensive treatment of burns of the upper respiratory tract with irradiation of the affected mucous membrane of the tracheoobronchial tree (TBD) with a low-energy laser, underwent laser irradiation of blood. Their use significantly reduces the term of burning burns with a good functional and cosmetic result. On average, for 4-5 days, the timing of healing of defects of mucosa of TBD decreased, the amount of pneumonium decreased by more than 20%, the economic indicators improved.

Head and spinal cord

During the year, more than 2500 patients are hospitalized in the neurosurgical clinic and about 1000 operations with modern technologies are carried out. Scientific developments concerning various sections of urgent neurosurgery are reflected in more than 20 monographs and 800 printed work and reports at international and All-Russian scientific conferences. For more than 40 years on the basis of the Institute, annual urban scientific and practical conferences and seminars are held in the specialty, and since 2003, on the basis of separation - master classes. Many branch staff were in the foreign clinics (Italy, France, USA, Belgium, Holland, Germany). Since 1998, on the initiative of the head of the department, the corresponding member of the RAMS, Professor V. V. Krylov and Professor V. V. Lebedev, published Neurosurgery magazine; Now he has more than 2000 subscribers and is sent free of charge. Mortality in the separation is 1.5 times lower than on average in Moscow. The priority of the department is an early surgical treatment of hemorrhages in the brain as a result of the breaking of vascular aneurysms, which reduces the frequency of fatal outcomes at these states almost 3 times (from 25 to 9%). Significantly better than all-Russian indicators and the results of the treatment of subdural hemorrhages. Methods of mini-invasive treatment of hemorrhagic strokes using microsurgical techniques have been developed. To a large extent, the treatment of weapons and brain injuries of peacetime and complications of the spine injury is greatly improved. The use of bone-plastic trepanation, drainage by hematoma through cutting holes, microsurgery aneurysm and malformations, local fibrinolysis of traumatic intracranial hematomas are expanding. NeurovideOendoscopy is used, minimally invasive thoracoscopic spondylodez, stryker neuroscope system and system for correction and stabilization of damaged spine.

Emergency Surgery

In 2005, emergency surgical interventions were carried out in 1560 patients. In the field of emergency surgery, the methods of early topical diagnostics and surgical treatment of mechanical liver damage using mini-invasive technologies have been developed and implemented in practice, which significantly reduces the frequency of repeated operations. For the diagnosis and treatment of perforative sawdodenal ulcers, diagnostic videosolparoscopy is widely used, and if necessary, a direct transition to mini-invasive operations from laparoscopic access, which is possible in 90% of cases. Methods of rapid treatment of complications of biliary diseases have been developed, including at high postoperative risks - the use of video-oposcopic technology, significantly improving the forecast in this pathology. In the treatment of pancreatitis, a preference is given to the mini-invasive puncture-drainage and video-panaroscopic interventions and manipulations about liquid clusters containing a large amount of toxic substances. Video chopperitoneoscopy is introduced, minilapotomy using the MiniSystem apparatus. For more than 20 years in a specially created department, a lot of work is carried out in such a difficult area as prevention and treatment of purulent complications in surgery. The methods of eliminating the sources of purulent complications are improved, including in the treatment of the most severe of them - peritonitis and intestinal fistulas. The principles of highly efficient closed aspiration and flushing treatment of valve processes were developed and widely implemented; equipment for its implementation; Antibacterial suture materials and preparations for local treatment of wounds. Created and used in many hospitals of the country surgical crosslinking devices (ACA-2, ACA-4, ACA-5M and LPK), the use of which significantly improves the results of operations on the organs of the digestive tract. The Institute is one of the four centers of Russia, where since 2000, liver transplantation is performed. To date, from 47 patients who have undergone this operation, alive 31 (66%). Other high-tech operations are produced in the department - hemigepatectomy, segmental and atypical liver resection. Herboring technologies have been introduced. In the departments of emergency vascular surgery and emergency cardiac surgery of the Institute, operations are carried out when the aneurysm of the chest and abdominal aorta is carried out, and for the prevention of ischemic strokes - operations on the neck vessels, aorta and its branches. The number of coronary shunt operations in 2005 was 139, of which the emergency - 95. In this case, the thermal imaging complex "Med-IR" is actively used to visualize the vessels during the diagnosis period and in the process of cardiac surgery operations. Auto-organizerial grafts are used to achieve more persistent remote results of coronary shunting. In conjunction with the separation of urgent thoracoabdominal surgery, in the separation of emergency plastic and reconstructive microsurgery, in addition to emergency restoration operations (replantations) with traumatic amputament of fingers and larger segments of limbs, as well as operations for damage to vessels and nerves of brush and forearm, microsurgical methods are introduced using their own Patient fabrics (autotransplantation) for plastics of the esophagus and trachea.

New Endosurgery methods are intensively developed in the laboratory of new surgical technologies. : Elimination of adhesive intestinal obstruction, embossing perforative ulcers, thoracoscopic operations in wounds and complications of closed breast injury, with bullous disease complicated by spontaneous pneumothorax, evacuation of rolled hemotorax, pneumaticism, pleurectomy, decortication, storage wounds, coagulation wounds of light and pleura, deletion foreign bodies, audit and drainage of the pleural cavity, resection of the lung. Together with the clinic of emergency toracoabdominal surgery, the practice was introduced new operation With severe closed injury, the chest is a thoracoscopic extrapleral subfascial fixation of floting fractures by ribs with knitting needles. VideoParoscopic operations are introduced into emergency gynecology. In the endoscopic separation, low-energy laser irradiation of the tracheosobronchial tree mucosa with thermal injury, chromicastroscopy, electric strooperography, esophagomanometry and impedancetry in order to control the gastroesophageal reflux during esophagus burns, as well as endoscopic ligation of the varicose veins of the esophagus and cardia are being introduced. For 2005, 10 270 medical diagnostic procedures were fulfilled. X-ray syrigious methods of diagnosis and treatment are also developing - angiographic studies, X-ray endovascular embolization of the aneurysm of the brain, gastric and uterine arteries during bleeding from them. For 2005, about 3,600 medical and diagnostic interventions were held.

Acute complications of ischemic heart disease

Among 318 patients with acute myocardial infarction (OIM) received for 2005, mortality was 8.8%, which is almost two times lower than the average in Russia. The institute is widely used thrombolytic therapy (including in the prehospital stage), emergency angioplasty and aorticorial shunting.

The Institute is one of the few medical facilities in the country, where the CCV is being developed and successfully applied - the percussion coronary interventions, and not only in the first 12 hours, but also for several days from the beginning of the heart attack. The CCV is successfully practiced with a high risk of fatal outcome, and with various forms of unstable angina, the use of CHKV allows you to achieve full disability. At the same time, the mortality from the OIM is reduced by 5 - 7 times and is absent at unstable angina and myocardial infarction without "q". IN last case The frequency of development of the OUT is reduced by more than 10 times, and the deadlines of inpatient treatment are significantly reduced. The Institute has the greatest and first experience in Russia with the experience of five successful PCVs at a traumatic myocardial infarction with damage to the intimate coronary artery, concomitant combined chest injury.

Acute poisoning and endotoxicosis

The Institute is the height of the toxicological service in the country. In the example of its toxicological department, it was decided to organize similar specialized centers in the USSR, the number of which today exceeds 40. Mortality during acute poisoning decreased by 2-3 times. This is especially important, since injuries and poisoning take second place among the causes of death mortality. Improving the quality of treatment of heavy poisoning has become possible through the use of technologies of accelerated elimination of toxicants from various sectors of the body (blood, intestines). These technologies developed in recent years in the treatment of acute poisoning (head-academician RAMN E. A. Luzhnikov) are based on the phased application of methods that contribute to the purification of the body (hemosorption, hemodialysis, intestinal lavage) and stimulation of its own protective forces during blood irradiation Ultraviolet and laser rays, effects on it with magnetic fields and indirect electrochemical oxidation. With this approach to the treatment of acute poisoning, the safety of used interventions is significantly increased by applying the effects of reduced intensity.

In 2005, 4,362 patients with non-media substances and toxic substances (alcohol, etc.) were hospitalized. About half of them (1954) were treated, due to the severity of the state, in the intensive care unit. The phased implementation in this separation of highly efficient therapeutic technologies led to a significant reduction in the frequency of fatal exodues - from 14% in 1983 to 7.7% in 2005. On the basis of the Institute, the federal state Institution "Scientific and Practical Toxicological Center", related to its activities with a toxicological clinic. Over the past period, up to 4-6 thousand telephone consultations (clinically and laboratory) - ambulance crews, hospitals, the population of Moscow, as well as other cities and institutions of Russia are provided annually. In addition, visiting consultations in the city and beyond, as a result of which a significant part of the patients translated from other hospitals to the toxicological department of the Institute. The service works around the clock.

For the treatment of acute endotoxicosis in the relevant department, modern high-tech methods of extracorporeal detoxification are used, including prolonged intensive sorption-membrane femachers (supervisory-technology), the advantages of which are mobility and broad healing opportunities. In 2005, 1060 extracorporeal detoxification procedures were held in the departments of the institute.

Hyperbaric oxygenation

During 2005, 6854 sessions of hyperbaric oxygenation were carried out in acute surgical and neurosurgical pathology, injury, acute poisoning, endotoxicosis, somatopsychiatric and other diseases, resulting in a reduction in the frequency of purulent-septic complications, accelerate the processes of detoxification, regress of psychoneurological disorders and other painful manifestations.

Restorative treatment

Recovery treatment includes physiotherapy and therapeutic physical culture and is carried out in patients who are in all clinics of the institute, as well as in ambulatory patients who need foliating after extracting from the hospital. This allows for the shortest possible time to achieve physical rehabilitation of patients after severe operations and various injuries. In 2005, a reducing treatment was covered by 3,903 patients, a total of 48,450 procedures were carried out.

Crisis Conditions and Acute Psychosomatic Disorders

The Institute has created a unique branch of emergency care for patients with acute mental disorders in combination with damage to internal organs requiring surgical interventions. Over the past year, about 2300 patients undergoing treatment under the past year. In recent years, the influx of persons affected by technogenic accidents, air and car accidents, terrorist acts and other emergencies have significantly increased. These patients experience powerful mental stress to eliminate psychological assistance. In 2001, a group of psychotherapists was formed and operating as part of the department. Clinical and psychological correction is carried out daily with patients experiencing mental stress associated with injuries, burns, identifying surgical diseases and upcoming operations. There were about 700 sessions of group and individual psychotherapy for nearly 170 patients affected by emergency situations. During recent years Psychotherapy on the developed technology was included in the treatment complex of more than 2000 patients with which about 5,000 psychotherapeutic sessions were conducted. The organization of psychological assistance in urgent states has no analogues in domestic health care.

Blood Service and Canning Tissues

The Institute is the height of the Harge-Keeping Surgery program. This is an important stage in improving the treatment of acute blood loss in surgery with autohemotransfusion, including its implementation in emergency and deferred operational interventions. The blood flowing inside and assembled during operations is processed by special technology and returns to the bloodstream. In urgent surgery, the Institute is currently used to 1.5 - 2 thousand liters of autobrov per year (in 2005 - 1.8 thousand liters), which significantly solves the problem of blood transfusion security problem and its components. With mass arrivals of persons affected by catastrophe or terrorist attacks, the transfusiological service of the institute takes a large stream of gratuitous donors (up to 1,800 people a week against 100 at normal time), while doing the work on promoting gratuitous donation and its rational use. Among the city branches of blood transfusion, the department of the institute ranks first in the number of attracted relative donors, the donation of which is 98% by 98%. In addition, alocory, bones, solid cerebral shell and cellular preparations, which are then used in clinical units, are harvested in the laboratory, which is then used in clinical units for the treatment of various lesions of the limbs and brain.

Laboratory and instrumental diagnostic complex

The institute has a large laboratory base for early diagnosis of urgent states. Only in 2005: about 27 thousand electrocardiographic, more than 150 thousand radiographic, about 50 thousand ultrasound, more than 20 thousand computer-tomographic, more than 6 thousand radionuclide and more than 15 thousand functional studies (various types of electroencephalography, spirometry , renowmography, intragastric pH-metry, etc.), more than 450 angiography. About 2.3 million clinical, biochemical, immunological, rheological, microbiological and toxicological analyzes were produced. In the laboratory for the diagnosis of viral hepatitis and HIV infection during 2005, about 330,000 people were examined (patients, donors, populations), about 1.2 million studies were fulfilled. The identification of infected persons allows the treatment and preventive measures to prevent the dissemination of infection in a timely manner.

(Mountains (Nord-Ost, Moscow, 2002); an explosion at the festival "Wings" in Tushino (Moscow, 2003); fire in the dormitory of the Russian University of Friendship of Peoples (Moscow, 2003); explosion at the Riga metro station ( Moscow, 2004); an explosion at the station "Avtozavodskaya" metro station (Moscow, 2004); Waterpark building collapse (Moscow, 2004); the effects of the terrorist attack in Beslan (2004); explosions at the metro station "Lubyanka" and "Park of Culture" ( Moscow, 2010); Terrorist attack at Domodedovo Airport (Moscow, 2011). In addition, the institute's staff systematically assist in various chemicals affected with mass poisoning.

Scientific Organizational and Academic Work

At the institute for more than 10 years, graduate school, doctoral studies in 6 specialties, clinical residency of 19 specialties, additional education programs implemented in accordance with federal programs. The Institute is trained not only by citizens of the Russian Federation, but also from the CIS countries and far abroad. About 150 clinical orders are prepared annually, 6-8 graduate students and 500 doctors under additional education programs. In the educational and clinical department are developed methodical manualsallowing doctors to use them as desktop books when providing medical care to the population.

At the base of the institute, the departments of higher educational institutions - Russian Medical Academy of Postgraduate Education (Department of Emergency Surgery and Clinical Toxicology), Moscow State Medical Dental University (Department of Neurosurgery of the Medical Faculty), Educational and Scientific Center at the Medical Center for the Office of the President of the Russian Federation (emergency department and intensive therapy). In the editorial and publishing department, which is successfully operating for more than 10 years, prepare for printing and publish the works of the Institute and its employees. The institute also has a rich scientific and medical library. The Department of External Scientific Relations is engaged in coordinating scientific research conducted outside the Institute, conducts a search and processing of scientific information, conducts work in the field of medicine history.

Recognition of the achievements of the team of the institute

For the long history of the Institute of Merit, its team has repeatedly noted higher organs States and city of Moscow. The larger achievements of the Institute refers to the documents of the People's Commissariat of Health of the RSFSR and the Presidium of the Mossoveta, published already in the first period of his work (1935).

The most significant rewards more late period - Order of the Labor Red Banner (Decree of the Presidium of the Supreme Soviet of the USSR of July 22, 1960) and Order of Lenin (Decree of the Presidium of the Supreme Soviet of the USSR dated August 14, 1973). The Institute also awarded a large number of diplomas, diplomas and prizes, testifying to its significant contribution to the country's health. Strong-rated house - Sheremetev hospital ambulance. N. V. Sklifosovsky always played a prominent role in domestic medicine. Being for many European countries and America, the institute, despite the changed living conditions of our society, successfully continues their activities. At the Institute, a modern material base has been created and a large team of highly qualified specialists storing and multiplying the best traditions domestic healthcare. This allows you to save patients and affected, previously considered hopeless, return to active activities Thousands of people, keeping their physical and mental health.

Scientific Research Institute named after Professor Medicine Nikolai Vasilyevich Sklifosovsky is widely known as the largest and wide-profile scientific and practical medical center of Russia.

Sklifosovsky Research Center

You just imagine, the Research Institute of Sklifosovsky has more than 40 scientific units, and at the same time half of them - clinical! The scientific and medical contingent of the Institute has more than 800 people, including 167 candidates of medical sciences, 37 professors, 6 people of deserved figures russian science, 78 doctors of science, 3 corresponding member of the RAMS and even three academicians.

On the basis of the clinic of the Sklifosovsky Institute with the help of modern high-tech methods, complex and unique operational interventions are carried out. From morning to evening, doctors of various profiles are assisted by residents of Moscow and regions, and some of the patients receive inpatient treatment. Researchum has at the disposal of 962 beds, including 120 (1-5 local) resuscitation chambers. And, of course, the numerous stream of patients receives emergency emergency for an ambulatory. In addition, the center has away medical brigades, ready if assistance is required, to provide it with other Moscow clinics and their patients.

Sklifosovsky Institute: Department and Service

In the structure of the medical center there are several divisions:

Five branches for the provision of emergency specialized assistance.
Seven diagnostic controls.
Six highly specialized profile compartments.
Vascular center of regional significance.
And other scientific, as well as auxiliary units, which include administrative and economic office departments.

In a single place so wide

In addition to restoring the health of patients, the research institutes of Sklifosovsky is engaged in educational activities, that is, specialists are undergoing additional training for advanced training. Moreover, the center is headed and conducts all sorts of scientific research workCommon medicine. Work is carried out daily to develop and improve diagnostic medical methods and their interaction with already known. Of course, the results obtained are successfully implemented into practice.

The separation of emergency vascular surgery is performed every day 24-hour city duty and spends only in Moscow to 50% emergency operations In patients with gap aneurysm in the abdominal department. Each year, the department exercises to 900 on the vessels. Such a significant amount of work performed by employees of the department is possible, thanks to the creation of a number of round-the-clock service.

Scientific and Practical Toxicological Center FMBA: Departments

Department of Physics of Living Systems (MIPT). Here professionals are prepared by applied physics and mathematics involved directly in areas such as biology, medicine, biomedical physics, computer science and engineering.
Department of Transplantology and Artificial Organs (MGMS). Experts receive theoretical knowledge and are trained in practical methods of examination of patients in need of high-tech medical care.
The Department of Neurosurgery and Neuroreanimations (University of MGMS) has the latest diagnostic equipment and ultra-modern operating rooms, in which the most complex operations are carried out with micronhurgehrogical equipment. For lectures and theoretical classes The department on all clinical bases is equipped with multimedia equipment and computers.
Department of Emergency and General Surgery (RMAPO), the main direction of which are repeated and reconstructive-reducing operations on the organs of the chest and the abdominal cavity.
Department of Clinical Toxicology (RMAPO). The essence of the main direction scientific work Departments: research and study of both the most common types and new forms of chemical disease, the development of medical technologies of detoxification and antidonate therapy of sharp poisoning.

Daily and round the clock

The daily round-the-clock work of the center is to provide urgent emergency people. The hospitalization of patients in the delivery of "urgent" teams is carried out, as well as the clinics, trauma, women's consultations and other medical facilities that have come across the directions.

In addition to the departure ambulance, the Research Institute of Sklifosovsky, employees conduct diagnostic advice, ultrasound research, MTP, radioisotope and functional diagnostics, as well as endoscopic procedures, including: rectosigmoscopy, rectosigmocolonoscopy, duodenoscopy, esophagastroduodenoscopy and fibrobronchoscopy.

On the high level The work of laboratory diagnostics in terms of generally clinical, microbiological, hematological, isocelological, coagology, histological, bacteriological and immunological studies is carried out daily.

List of paid services research and price

Sklifosovsky Research Center for all wishing provides a number of paid services. Treatment on a contractual basis basis requires preliminary paperwork and check out. Cabinet for recording and decoration is in Central Research Institute. Extracting medapates and payment for services must be made on the day of the patient's reception at least 15-20 minutes before the designated time. What is the institution of Sklifosovsky paid services? All citizens can get:

Diagnostic medical counseling on the issue of pain and its treatment. Cost - 2000 rubles.
Blockade under ultrasonic control or radiological (C-arc) therapeutic diagnosis. The cost of the procedure is 9900 rubles.
Therapeutic and diagnostic blockade in conjunction with the installation of a catheter under X-ray (C-arc) and ultrasound control. Cost - 11640 rubles.
Radio frequency service (impulse therapy, radio frequency denervation). Cost - 30,400 rubles.
Intra-articular administration of hyaluronic acid preparations. Cost (excluding the cost of medication) - 1900 rubles.
Drip administration of analgesics (intravenous). Cost - 3000 rubles.
Observation, consulting support of the postoperative period (with treatment based on system analgesia). Cost - 10,000 rubles.
Consultation support of the postoperative period with treatment based on systemic and regional analgesia. Cost - 15,000 rubles.

How to get to the Research Institute Sklifosovsky? Address establishment

Muscovites are well known where the famous medical center is located. But daily in the capital for highly qualified treatment comes a large number of people from the regions. People want to get to the Sklifosovsky Institute. How to get to the medical center? There is nothing difficult in this. It is only necessary to get to the station "Prospect Mira" or "Sukharevskaya". From any of these stops, you can get to the research institute of Sklifosovsky in 5-10 minutes. Address of the establishment: 129090, Moscow, Bolshaya Sukharevskaya Square House 3.

It will be enough to visit the medical center once once, and the question of how to find it will be closed forever.

Reviews about them N. V. Sklifosovsky

Most patients with warmth and gratitude belong to the doctors of the Research Institute. Numerous reviews about the timely provided assistance, correctly delivered diagnoses and well-carried out complex operations are talking about high competence and professionalism of clinic doctors. By the nature of your activities, the work of the doctor is a titanic work that helps people gain health and happiness. And the doctors of the Sklifosovsky Institute have many state awards For professionalism. And it says about many.

But, unfortunately, you can meet negative feedback in which resentment on specific specialists were expressed. Such comments usually relate to their relationship to the patient. The administration of the clinic does not disregard every case, responding with reprimanding or recovery from the employee who violated the ethics of the medical center. This suggests that the heads of the Nii named after Sklifosovsky will value the clinic reputation. But good reviews, of course, much more. It is especially nice to read them about those situations where the case concerned the salvation of human life, where such a miracle played a major role as the skill of the doctor.

Services provided at the Sklifosovsky Institute

The medical center of Sklifosovsky provides many different services that can be divided into separate groups:

Ambulance to them. Sklifosovsky is equipped with a modern technical base, this fact in aggregate with constantly conducted research and scientific developments allows you to achieve large heights. The fact that yesterday was considered impossible, today already replenishes a number of scientific achievements available for use. Thanks to this, the doctors of Sklifosovsky have the opportunity to assist even with such patients who were previously considered hopeless. Here daily take a height of height daily to make humanity heavily, active and successful.

Department of Neurosurgery and Neuroreanimation of MGSU in the Research Institute of Sklifosovsky

The Department of Neurosurgery on the Medical Faculty of MGMS was created on July 23, 2003 on the basis of the decision of the Academic Council. As practical science, neurosurgery stood out into separate independent discipline. The diagnostic methods became more improved, the indicator of the significance of this discipline in the structure of the provision of high-quality neurosurgical assistance has grown. Such departments of Sklifosovsky, as well as resuscitation, began to need specialists with the required special preparation, as a result of which the existing department was renamed to the Department of Neurosurgery and Neuroreanimations on the basis of the University signed by the University Council No. 7.

The main directions of pedagogical work department

As a postgraduate education of the Department of Scliffosovsky "Neurosurgery and Neuroreanimation", organizes master classes on a variety of issues in the field of urgent neurosurgery relating to non-immoral intracranial hemorrhages, cranial injuries and so on. Classes are enriched with lectures of leading specialists, clinical cases and indicative operations on anatomical layouts. The base of the department is a separation of ambulance to them. N. V. Sklifosovsky.

To get to the treatment at the neurosurgery department is possible:

Having received the direction of the Moscow ambulance station.
By writing through the consultation office of the center towards the Moscow Medical Institutions.
On a paid commercial basis through the contractual department of the institute.

Little rows of the history of the emergence of the Research Institute

How it all began, you can only find out from archival sources. And they say that in 1803, Count Nikolai Petrovich Sheremetyev organized a patronage mission to develop science. He bought a house and determined one part of it for a mini-hospital for 50 people, and the second - under the girl's shelter for 25 orphans. So it was created the first institution in our country to provide medical care to the poor in the population.

During the war of 1812, the hospital for the wounded French army was first located in an organized Sheremetyev altogether, then the wounded soldiers of the Russian-Turkish war came here. The participants of all subsequent wars also received medical care here. Since 1815, there was a permanent surgical practice here. And on this, already accomplished medical base, an emergency institute was organized.

Why is the name of Professor Sklifosovsky?

In 1929, the institution began to be called in honor of N. V. Sklifosovsky for his work on practical surgery for which war time in urgent order Trained specialists. Such doctors had to practically apply the knowledge gained in practice. During the war, the flow of the wounded did not stop, and the works of professors concerning the operations on the abdominal cavity, antiseptics, resection of the jaws and even cutting the goiter saved the lives to many wounded fighters. It was the merit of Sheremetyeva named in his honor right.

Sklifosovsky himself during the military campaigns acquired a rich practical experience, as he worked in dressing points, a surgeon-consultant, a military-field surgeon and the leading surgeon of the Russian army. His military activity gave considerable material to publish a number of works on military medicine and sanitation.

Streamlining and growth

The ambulance station located in the territory of the Sheremetyevsk hospital, which was led by which at the time of G. M. Gerstein, began to be listed by the department of the Institute. He was then headed by A. S. Puchkov, under the guidance of which a well-established system of documentation and reporting was created. It greatly facilitated the work of the staff, organizational principles were developed, as well as technical retrofit, as a result of which the work of the department climbed to a new qualitative level. Until the most fortunately, the station remained as part of the institute, and later was allocated to a completely independent organization.

The Sklifosovsky Institute became a pioneer-innovator in the organization of emergency surgical service. Its basic principles were formulated, such as providing qualified operational assistance at any time, the morning conference on the discussion of work per day, participation in the diagnosis of radiologists and so on.

The first to put up the question of the need for preventive work relating to the prevention of accidents, and actively contributed to the adoption of a number of measures to help secure the household side of the life of the population of Moscow.

From military to peacetime

The number of accepted wounded soldiers during the years of the Great Patriotic War Institute. N. V. Sklifosovsky passed for tens of thousands. Everyone was provided with the necessary help. To save the lives of many of them, it was urgent immediately to carry into operations. Here was the most complicated operations to save lives of warriors and returning them into operation. Then, many existing surgeons and medical sisters of the Sklifosovsky Center worked on the advanced fronts. Hospital hospital was reorganized in accordance with the tasks of peacetime.

During last decade In the medical center of Sklifosovsky there is a training and clinical department, annually producing up to two hundred orders. We opened and successfully function graduate studies and doctoral studies in such specialties as cardiology, anesthesiology and resuscitation, traumatology and orthopedics, surgery, neurosurgery, cardiovascular surgery. The editorial and publishing department of the Center is preparing to enter into print scientific works of research institutes. In addition to all this, the Institute boasts the presence of a rich scientific medical library.

In the Research Institute of Sklifosovsky, which emerged two centuries ago, on the basis of hospital-shelter, in the entire history of existence, a lot of doctors famous in the global medical community worked. Health is the most valuable gift for a person. And you need to take it as stronger as possible. Unfortunately, sometimes, even regardless of our accuracy and caution, accidents, burns and injuries occur, requiring urgent and immediate medical intervention. It is for this that there is a Sklifosovsky Institute. Here you at any time of the day are ready to assist.