Журнал «Травма» Том 16, №4, 2015
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Analysis of the immediate causes of death in patients with multiple injuries and injuries of the skeleton
Авторы: Guriev SE, Fil A., Tanasienko ON — State Ukrainian scientific-practical center of emergency medical care and disaster medicine, Kiev, Ukraine
Рубрики: Травматология и ортопедия
Разделы: Клинические исследования
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Ключевые слова
polytrauma affected, mortality, traumatic illness
Introduction:
Now in Ukraine, as almost everywhere, there is a significant increase in the level and severity of traumatic injuries of man, which allowed some authors to introduce the concept of injury epidemic particular importance, both in terms of complexity and in terms of threat to life, combined with injury, which is a very difficult problem for the world of medical science and health. The above problem is one of the most pressing as for public health Ukraine
Мaterials and Methods:
To address the problems of research in this context we used array 2, which included 169 trauma cases fatal. The entire array of research was divided into two groups. The first group consisted of 94 victims of polytrauma and skeletal injuries whose treatment ended lethally. These were the main group affected. The second group of 75 patients with polytrauma without damaging the skeleton that also died and formed a control group.
Results and discussion: Аmong patients with polytrauma with skeletal component and without death there in different periods of traumatic disease. So among victims component of skeletal trauma often die in shock period, but then as victims of polytrauma without fatal skeletal component occurs at a later date, but rather unstable during adaptation. During unstable adapt mortality among patients with skeletal injuries and reduced and stabilized in a stable period of adaptation. Among the victims polytrauma without skeletal component during unstable adaptation comes the peak of mortality, which also stabilized in the stable period of adaptation. Рolytrauma victims of both skeletal damage and without it most often die of acute cardiovascular disease. Comparing the frequency of causes of death in the experimental groups, we concluded that among victims component of skeletal trauma shock occurs more often than among patients with polytrauma without skeletal component.
Conclusions:
1. The main cause of death among patients with polytrauma and skeletal damage is acute cardiovascular failure, which is also in the main chynoyu death in victims without damaging the skeleton;
2. Among patients with polytrauma and skeletal damage occur much more frequently death from cerebral edema, which indicates the severity of the traumatic process among patients in this category;
3. Shock is a frequent cause of death among patients with damage to the skeleton, which must be considered in the planning of diagnostic and treatment tactics in these patients.