Russian Research Neurosurgical Institute. prof. AL Polenov Russian Ministry of Health
Severo West State Medical University named after II Mechnikov
Brief summary
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.
Key words
craniocerebral trauma, extracranial damages, polytrauma, algorithm of diagnostics.
1. Agadjanyan, V.V. Politravma. Neotlojnaya pomosh i transportirovka / V.V. Agadjanyan, I.M. Ystyanceva, A.A. Pronskih i soavt. – Novosibirsk: Nayka, 2008. – 320 s.
2. Ankin, L.N. Politravma (organizacionnie, takticheskie i metodologicheskie problemi) / L.N. Ankin. – M: MEDpress-inform, 2004. – 176 s.
3. Bagnenko, S.F. Obshie principi otbora ychrejdenii zdravoohraneniya, na baze kotorih vozmojno i celesoobrazno formirovanie travmocentrov razlichnogo yrovnya. / S.F. Bagnenko, V.V. Stojarov, A.G. Miroshnichenko i soavt. // Skoraya medicinskaya pomosh. – 2009. – № 4. – S. 64–71.
4. Borovkov, V.N. Tyajelaya sochetannaya travma v stryktyre dorojno-transportnogo travmatizma. Snijenie smertnosti na gospitalnom etape / V.N. Borovkov, G.V. Sorokin, N.V. Borovkov // Materiali II Moskovskogo mejdynarodnogo kongressa: Povrejdeniya pri dorojno-transportnih proisshestviyah i ih posledstviya: nereshennie voprosi, oshibki i oslojneniya. – M., 2011. – S. 15–16.