IMPROVEMENT OF DIAGNOSTIC METHODS FOR THORACOABDOMINAL INJURIES

Abstract

Relevance. The relevance of chest injury is due to an increase in the frequency of injuries, the complexity of diagnosis, the severity of the course and an increase in the number of deaths. High mortality is caused by injuries to organs necessary for life, the development of hemodynamics, respiratory disorders and ranges from 2.6% to 29.3%. In complicated chest injuries, diagnostic and tactical fractures occur in 1/3 of patients. The causes of diagnostic errors in chest injury depend not so much on the severity of the affected and concomitant pathology, as on the incomplete and untimely application of the entire complex of diagnostic methods. Therefore, the discussion of unresolved issues continues when choosing effective diagnostic methods.
Objective. Improvement of diagnostic methods for chest injuries. Information about the method of application of the author's technique in the process of ultrasound examination and its importance in rapid diagnosis.
Material and methods. A retrospective analysis of a copy of the patients' medical records was carried out. As an object of research, Almaty has 75 patients hospitalized in the period from 2021 to 2023 by the National Scientific Surgical Center named after A. N. Syzganov and KKA No. 7.
Research results. The predominance of symptoms of damage to the chest and abdominal organs (T+A+) was most often observed in patients with TAP, regardless of the side of the injury (48%). The absence of a pronounced symptom complex of injuries to the chest or abdominal cavity (T-A-) was observed in patients with TAP on the right and it was 15.4%, which was twice as high as these indicators on the left – 6.1%. The defining symptom complex in the clinic was the picture of intra–abdominal bleeding (60%) and this indicator was higher in patients with TAP on the right - 80.8%. The clinic of peritonitis in patients with injuries on the left was observed in 34.7% of patients, on the right these symptoms were absent.
Discussion of the results .The results of the study show with massive intra-thoracic bleeding, the use of in-depth examination methods becomes impossible. At the same time, the advantages of ultrasound can be noted, ultrasound can be performed directly in the ward or operating room, in any position of the patient and under any lighting. Ultrasound examination is performed without prior preparation of the patient. At the same time, ultrasound examination shows an image in the form of the formation of gas bubbles along the wound canal and in hollow areas having a penetrating nature of the wound with the use of hydrogen peroxide.
Conclusion. The proposed ultrasound diagnostic method determines the nature of the injury of penetrating chest wounds, has no radiation exposure, prevents complications associated with late diagnosis, is safe and less traumatic, reduces the risk of damage to adjacent structures and tissues.