INFLUENCE OF ORGAN DYSFUNCTIONS ON THE OUTCOME OF THE SHARP PERIOD AT PATIENTS WITH THE POLYTRAUMA
Aim. Diagnostics results and treatment improvement of polytrauma acuity by assessment of cerebrum metabolic dysfunction in patients with cranium-brain-concomitant trauma. Materials and methods. In present research work analyzed the results of diagnostic and treatment of 86 patients with concomitant trauma (61man with productive age and 25 women) For analyses of received findings patients were divided in two groups: I - 47 (54,7%) with bulbar dark blood, treatment methods executed on the base of orthopedic damage control for 4 phases; to II - 39 (45,3%) applied generally known methods and diagnostics. To all patients conducted complex clinic and special examination. Metabolic activity of brain analyzed by research method of clotting findings, rheology and electrolyte of bulbar dark blood. Results. Purposeful conduction of complex of conservative and surgical treatment of patient in acuity reduced proportion of complications in patients of the first group (with cranium-brain-concomitant trauma) on 7,3% (treatment management on the ground of orthopedic damage control), unacceptable results of treatment on 4,8% and patient day-in average on 6,1% in comparing with identical findings in second group of patients, to whom applied generally known methods and diagnostics of concomitant traumas components. Analyzing the electrolytic exchange findings we ascertain that in proportion to severity of injury occurred retention Na+ in erythrocytes and Na+ plasm in brain, bland texture and it became the reason of interstitial edema progression. Conclusion. Treatment management in patients with cranium-brain-concomitant trauma is necessary to develop in compliance with the damage characteristics of metabolic activity of brain and bland, results of objective evaluation criterion points of damages severity and principals of orthopedic damage control.