Abstract
Objectives. To make analysis of main types of surgeries performed at various neck wounds in civil medical institution in the conditions of the local military conflict.Patients and methods. The work is based on a retrospective analysis of the treatment of 241 patients with various neck wounds who were admitted in an urgent order to the surgical department of a city hospital in Chechen Republic from 1991 to 2000. All the wounded were divided into two groups: 129 with gunshot wounds (main group) and 112 with stab wounds of the neck (comparison group). The average age was 35 ± 5 years, dominated by males — 78%.Results. It was established that in 25 (19.3%) cases the operation was started under local anesthesia, in 45% of cases anesthesia was given to continue the surgery, in 84% intubation was made, in 16% — intravenous operations. As a result of the analysis, it was revealed that for neck gunshot wounds the following operations were most often performed: a typical tracheostomy without a laryngeal and tracheal suture in 26.3% cases; atypical tracheostomy without suture of larynx and trachea — 16.2% cases; the laryngeal or tracheal suture with tracheostomy was performed in 13.1% cases, in 12.4% of cases was performed operative exploration of neck organs.In cases of concomitant chest wounds, in 10.8% of cases, in addition to operative exploration of neck organs, thoracotomy was performed, in most cases for suturing wounds of the esophagus.Conclusion. The study confirmed that in the wounded with neck gunshot wounds, the amount of aid consisted primarily in restoring airway patency, stopping bleeding and anti-shock actions.
Highlights
Число больных с ранениями шеи не уменьшается в связи с неблагоприятной криминальной обстановкой и наличием локальных военных конфликтов
To make analysis of main types of surgeries performed at various neck wounds in civil medical insƟtuƟon in the condiƟons of the local military conflict
The work is based on a retrospecƟve analysis of the treatment of 241 paƟents with various neck wounds who were admiƩed in an urgent order to the surgical department of a city hospital in Chechen Republic from 1991 to 2000
Summary
Работа основана на ретроспективном анализе лечения 214 раненых с различными ранениями шеи. Все раненые были госпитализированы в экстренном порядке в хирургическое отделение, которое было расположено на базе больницы No 9 г. Раненые были разделены на две группы: 129 было с огнестрельными ранениями (основная группа) и 112 — с колото-резаными ранениями шеи (группа сравнения). В основной группе преобладали пулевые ранения с различным калибром и видом — 96 (74,4%). В группу сравнения вошли 112 пациентов, которые получили ранения в шею колото-режущими предметами. Для определения тяжести травмы ретроспективно использовалась шкала «ВПХ-П» [3]. Для оценки тяжести состояния раненых в момент поступления применялась шкала «ВПХ–СП» [3]. В нашем случае оценка по этим шкалам выполнялась ретроспективно, с помощью оценки данных, представленных в медицинских картах. Для проведения статистического анализа полученных в результате исследования данных использовалась статистическая программа Statistica 6.0. К статистически достоверным величинам относили различия между сравниваемыми величинами при значении р < 0,05
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