Russian Research Neurosurgical Institute. prof. AL Polenov Russian Ministry of Health
Severo West State Medical University named after II Mechnikov
Research objective – specification of features of diagnostics of craniocerebral and extracranial damages at multiple and combined trauma.
Material and methods. The retrospective analysis of diagnostics of 1946 victims with a polytrauma made. Specific weight of various beam researches differed. The CT-research including inspection of a brain, facial skeleton, cervical and chest departments of a backbone, bodies of a thorax and pelvic bones, was undertaken at 23.3% of victims. At 18.1% cases, the X-ray that caused by the considerable specific weight of fractures of bones of extremities was used.
Results. Owing to features of a clinical course of a polytrauma for the first 3 hours after hospitalization, a number of damages did not diagnose for 19.2% of victims: fractures of bones of the arch and basis of a skull, pelvic and backbone, multiple fractures of edges, shovels, bruise of a lung and hemotorax.
The average time spent for research of one patient at performance of CT of the head and cervical department of a backbone, averages 14.5±3.5 min., at this CT possesses high informational content. Process of CT-research of the head, cervical, chest and lumbar departments, and pelvic takes on the average 30.5±3.5 min.
Conclusions. Clinical feature of a polytrauma is development of syndromes of mutual burdening and overlapping, and various cerebral and somatic pseudosyndromes that significantly complicates diagnosis statement. Feature of a choice of beam methods at a polytrauma is expediency of use of CT owing to a combination small on time of duration of research (on the average no more than 30.5±3.5 min.) and its high informational content (sensitivity – 95.2%, specificity – 95.8%, accuracy – 95.6%), and at suspicion on an injury of extremities – X-ray.
craniocerebral trauma, extracranial damages, polytrauma, algorithm of diagnostics.
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