军事行动中地雷和爆炸伤受害者的外科治疗

S. Teslenko
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摘要

总结。地雷爆炸伤是由于工程、地雷弹药爆炸的冲击因素的影响而发生在人体身上并伴有深度和广泛的组织损伤和挫伤的枪弹复合多发伤。本文的目的是分析戒严条件下地雷炸伤患者的手术治疗方法。材料和方法。对64例地雷炸伤患者的手术治疗结果进行了分析,其中27例(42.2%)为女性,37例(57.8%)为男性,均在Dergachiv中心医院接受治疗。根据受伤部位、性质、患者的严重程度、创伤性休克或失血性休克的发展情况,所有受害者都接受了手术干预。结果和讨论。鉴于最常见的损伤类型是不同部位的伤口,最常见的手术干预类型是对伤口进行手术治疗。干预的范围取决于伤口的深度和大小,以及组织损伤的性质。采用手术手法消除气胸(气水胸),胸膜穿刺或胸腔引流。如果Rouvilois-Gregoir试验呈阳性,则进行开胸手术,然后缝合肺伤口。有创诊断方法,对怀疑有腹腔脏器损害的行腹腔镜、腹腔镜检查,排除腹腔脏器损害。在这种情况下使用腹腔镜,虽然其诊断价值低于视频腹腔镜,但可以确定腹腔内的病理内容,这足以发现危及生命的腹部损伤后果,例如腹腔内出血。结论。具有爆炸性病变的受害者需要在各个解剖区域进行大量的手术干预。在向爆炸伤害受害者提供援助时,应以“损害控制”原则为指导,根据生命体征确定应采取的干预措施的数量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
SURGICAL TREATMENT OF VICTIMS WITH MINE AND EXPLOSIVE INJURIES DURING MILITARY ACTIONS
Summary. Mine-explosive injury is a gunshot combined multiple injury that occurs in a person as a result of the impact of the impact factors of the explosion of engineering, mine ammunition and is accompanied by deep and widespread tissue damage and contusion. The purpose of the work is to analyze the methods of surgical treatment of patients with mine-explosive injuries in the conditions of martial law. Materials and methods. The results of surgical treatment of 64 patients with mine-explosive injuries were analyzed, 27 (42.2 %) were women, 37 (57.8 %) were men, who were being treated at Dergachiv Central Hospital. All victims underwent surgical interventions depending on the location of the injury, its nature, the severity of the patient, the development of traumatic or hemorrhagic shock. Results and their discussion. Given that the most frequent type of injuries were wounds of various localization, the most common type of surgical intervention was surgical treatment of wounds. The scope of the intervention depended on the depth and size of the wound, as well as the nature of tissue damage. Surgical manipulations on the chest were performed to eliminate pneumothorax (pneumohydrothorax), pleural puncture was performed or pleural drainage was established. If the Rouvilois-Gregoir test was positive, a thoracotomy was performed followed by suturing of the lung wound. Invasive diagnostic methods, laparocentesis and laparoscopy were performed for suspicion of damage to the organs of the abdominal cavity, with the help of which damage to the organs of the abdominal cavity was excluded. The use of laparocentesis in such situations, although its diagnostic value is lower than that of video laparoscopy, allows to determine the pathological content in the abdominal cavity, which is sufficient to detect life-threatening consequences of abdominal injuries, for example, such as intra-abdominal bleeding. Conclusions. Victims with explosive lesions require a large number of surgical interventions in various anatomical areas. When providing assistance to victims of an explosive injury, one should be guided by the principles of “damage control”, determining the amount of interventions that should be performed based on vital indications.
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