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Синдром множественной органной дисфункции в течении изолированной черепно-мозговой травмы у больных в критическом состоянии

Синдром множественной органной дисфункции в течении изолированной черепно-мозговой травмы у больных в критическом состоянии

Abstract

Specific weight of the closed craniocereberal trauma at patients takes the 3rd place in structure of a lethality of the population. High frequency of occurrence of a craniocereberal trauma, lethality, development of polysystem dysfunction at this pathology defined the purpose of the real research. Studying of degree of expressiveness and influence on an outcome of a disease of a syndrome of multiple organ dysfunction at patients with the isolated craniocereberal trauma was carried out. 30 clinical records of patients with the isolated closed craniocereberal trauma, aged from 18 till 50 years, without accompanying pathology are retrospectively studied. The assessment of cerebral insufficiency, external breath, gas transmission function of blood, liver function, condition of proteinaceous and carbohydrate exchanges, functions of kidneys, a gastrointestinal path was carried out. Quantitative indices of the central haemo dynamics, level of endogenous intoxication were studied. Researches were conducted in the first, third, seventh and tenth days. The obtained data were processed by the main methods of variation statistics with calculation of the following criteria: selective average, average error of a selective average. Formation fact in evidence a syndrome of multiple organ dysfunction at patients with the isolated closed craniocereberal trauma. Various degree of expressiveness of dysfunctions of studied systems on different terms of the closed craniocereberal trauma is revealed. The interrelation between expressiveness of dysfunction, number of the involved systems and an outcome of studied pathology is found. Involvement in the syndrome of multiple organ dysfunction functional systems is carried out by a mixed way. When the comparison between the groups of patients with different outcome degree of dysfunction of each of the systems in the group of patients with fatal outcome in average 30% higher.

Удельный вес закрытой черепно-мозговой травмы у больных занимает 3-е место в структуре летальности населения. Высокая частота встречаемости черепно-мозговой травмы, летальность, развитие полисистемной дисфункции при данной патологии определили цель настоящего исследования. Осуществлялось изучение степени выраженности и влияния на исход заболевания синдрома множественной органной дисфункции у больных с изолированной черепно-мозговой травмой. Ретроспективно изучено 30 историй болезни пациентов с изолированной закрытой черепно-мозговой травмой в возрасте от 18 до 50 лет без сопутствующей патологии. Проводилась оценка церебральной недостаточности, внешнего дыхания, газотранспортной функции крови, функции печени, состояние белкового и углеводного обменов, функции почек, желудочно-кишечного тракта. Изучались количественные показатели центральной гемодинамики, уровня эндогенной интоксикации. Исследования проводились в первые, третьи, седьмые и десятые сутки. Полученные данные обрабатывались основными методами вариационной статистики с расчетом следующих критериев: выборочного среднего, средней ошибки выборочного среднего. Доказан факт формирования синдрома множественной органной дисфункции у больных с изолированной закрытой черепно-мозговой травмой. Выявлена различная степень выраженности дисфункций изучаемых систем на разных сроках закрытой черепно-мозговой травмы. Обнаружена взаимосвязь между выраженностью дисфункции, количеством вовлеченных систем и исходом: вовлечение в синдром множественной органной дисфункции функциональных систем происходит по смешанному пути. При сравнении групп пациентов с различным исходом степень дисфункции каждой из систем в группе пациентов с летальным исходом в среднем выше на 30%.

Keywords

СИНДРОМ ПОЛИОРГАННОЙ ДИСФУНКЦИИ, ЗАКРЫТАЯ ЧЕРЕПНО-МОЗГОВАЯ ТРАВМА, ПОЛИСИСТЕМНАЯ ДИСФУНКЦИЯ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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