Evich Y. Diagnostics and treatment of injuries of the diaphragm.

The dissertation deals with the theoretical aspect and new decision of problems of diagnostic and treatment of the injuries of the diaphragm (ID) in wound and blunt traumas of thoracoabdominal region. The questions of diagnostics were researched, the comparative analysis of diagnostic values of clinical studies were made, image and endoscopic methods, the algorithms of diagnostics ID in wound and blunt traumas of thoracoabdominal region were searched. The clinical symptoms. X-rayed (manipulation of DT), ultrasonographics and CT-serniotics, peculiarities of thoracoscopic and laparoscopic visuality ID were described, the typical ID symptoms of wound and blunt traumas of thoracoabdominal region were defined, the cause of possible diagnostic mistakes were analyzed. The comparative analysis of diagnostic value of clinical research, image and endoscopic methods were made, the sensibility, specifics, positive and negative prognostic values were estimated. The algorithms of diagnostics ID of wound and blunt traumas of thoracoabdominal region were researched. The ways for treatment of injuries with ID were studied. The devices (fixator of diaphragm, multiused atraumatic needle, hemostasis device wich use for decreasing the duration of a operation, volume of intra-operation hemorrhage, the number of complication) were offered, the clinical effectiveness these devices were estimated. The method of risk decrease of after-operational inflammatory was described by way of behind-operational antibiotic prophylactics, the effectiveness of its usage was proved statistically.