EFFECTIVENESS OF THERAPEUTIC TACTICS FOR ANALGESIA OF PATIENTS WITH GUNSHOT AND MINE-EXPLOSIVE WOUNDS AT THE STAGES OF TREATMENT

I. Kuchyn, V. Horoshko
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Abstract

Background. The effectiveness of the use of therapeutic tactics for pain relief at the stages of treatment is important considering the fact that chronic pain is diagnosed in 83.3% of patients with mine-explosive wounds, and in 70% of cases with gunshot wounds. In civilian life, among injured patients, this diagnosis occurs in 11-40% of cases. There is not enough data on the reasons for such a high frequency of chronicity. Thus, the study of the effectiveness of treatment tactics for pain relief in patients with gunshot and mine-explosive wounds at the stages of treatment will play an important role and contribute to improving the results of treatment of this category of patients. Aim: To investigate the effectiveness of therapeutic tactics of analgesia in patients with gunshot and mine-explosive wounds at the stages of treatment. Materials and methods. The treatment of 1166 patients with injuries was analyzed. Pain intensity was diagnosed using a visual analog scale. Group comparisons were performed using the Mann-Whitney test and the chi-square test with allowance for continuity correction, Kruskal-Wallis, and post hoc comparisons were performed using Dunn's test. Results. In patients with gunshot wounds, during the analysis, it was found that VAS data significantly depend on the type of anesthesia. Using regional anesthesia, VAS data are the lowest at all measurement points (p<0.05). In patients who received landmine-explosive injuries, VAS data are weakly dependent on the choice of anesthetic support, however, this indicator still has higher values (p<0.05) when using general anesthesia. Two-factor analysis showed a relationship between the dynamics of VAS data and the type of injury (p<0.001), type of anesthesia (p<0.001). Conclusion. Admission of a patient with a wound to a medical center with subsequent analgesia using regional anesthesia methods has the best outcome in terms of pain management and pain control in such patients.
枪炮和地雷爆炸伤患者治疗阶段镇痛治疗策略的有效性
背景考虑到83.3%的地雷爆炸伤患者和70%的枪伤患者被诊断为慢性疼痛,在治疗阶段使用治疗策略缓解疼痛的有效性很重要。在平民生活中,在受伤患者中,这种诊断发生在11-40%的病例中。没有足够的数据来说明慢性病发生频率如此之高的原因。因此,研究枪伤和地雷爆炸伤患者在治疗阶段的疼痛缓解治疗策略的有效性将发挥重要作用,并有助于提高这类患者的治疗效果。目的:探讨枪雷爆炸伤患者治疗阶段镇痛策略的有效性。材料和方法。对1166例外伤患者的治疗进行了分析。使用视觉模拟量表诊断疼痛强度。使用Mann-Whitney检验和卡方检验进行分组比较,并考虑连续性校正,Kruskal-Wallis,使用Dunn检验进行事后比较。后果在枪伤患者的分析中,发现VAS数据在很大程度上取决于麻醉类型。使用区域麻醉时,VAS数据在所有测量点都是最低的(p<0.05)。在地雷爆炸伤患者中,VAS数据对麻醉支持的选择依赖性较弱,但在使用全身麻醉时,该指标仍然具有较高的值(p<0.05)。双因素分析显示VAS数据的动力学与损伤类型(p<0.001)、麻醉类型(p>0.001)之间存在关系。将有伤口的患者送入医疗中心,随后使用区域麻醉方法进行镇痛,在这些患者的疼痛管理和疼痛控制方面具有最佳效果。
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