Kapshytar O. The pecularities of diagnostics and treatment of the injured persons with the isolated and combined closed liver injuries

The author analyzed in full the diagnostics and treatment of 110 injured persons with the closed traumatic liver injury. The combined liver injuries are prevailed with the 90,9 % of the patients. The liver injury with the 92,5 % of the injured patients has become acute by the bleeding, 15,6 % - had the acute multiple organ failure, 2,8 % -peritonitis.Viewing the severity of the injured liver the ill persons are divided into three groups per the LIS modification scale: 24,5 % of the patients had the I light grade of severity (APACHE II up to 10 points; ISS 25 points); 36,4 % had the II average grade of severity ( APACHE II - 11-20 points; ISS 25-40 points , 39,1 % - the III heavy grade of severity ( APACHE II 21 points; ISS 40 points).The laparotomy is the basic treatment method of the suffered persons, it is attended by the high per cent of the postoperative complications.The acute hepatic failure is the bad complications of the postoperative period. The use of the membrane stabilizers ( essenciale, heptral, tiotrasolin) resulted by the reduction of the acute hepatic failure from 19,2 % up to 7,7 % and the lethality up to 33,3 % ( as compared with the 80 % in the comparison group).In the given candidate's thesis one can see the outcome of the investigations of the various diagnostic methods including those developed by the author, the isolated and combined closed hepar injury, the developed blood keeping technologies, the choice of the method and scope of the operations, the use of the developed hepatic suture while the liver rupture and resection, the compared estimation of the operative interventions is given, the use of medical laparotomy, implementation of the membrane stabilizers, the developed protocol of diagnostics of the injured liver upon the closed abdominal injury and algorithm of arrangement-tactical assistance to the injured with the isolated and combined closed liver injuries that allowed to improve the treatment results