Chaika V. Justification use minimally invasive methods of diagnosis and treatment of abdominal injury combined with traumatic brain injury

In this dissertation were shown features of the distribution and structure of combined abdominal and brain injury in peacetime in modern conditions regional department of specialized polytrauma. The frequency of symptoms of damage to the abdominal cavity and their diagnostic informative in the diagnosis of closed abdominal trauma in patients with combined abdominal and brain injury were determined. An assessment of the possibilities of videolaparoscopy and proved its danger in patients with combined abdominal and brain injury with different degrees of severity of brain injury by studying indicators of multiple organ failure on MODS, level of consciousness brain injury, level of intraabdominal preassure, parameters of gas composition and pH of blood in the postoperative period. Also clearly defined place videolaparoscopy in the algorithm for diagnosis and treatment of abdominal injury combined with traumatic brain injury depending on the amount of free blood in the abdominal cavity. The use of advanced diagnostic and therapeutic algorithm has reduced the time of diagnosis blunt abdominal trauma from 2,94 ± 0,54 hours to 1,26 ± 0,62 hours to reduce the percentage of explorative laparotomy from 15,0% to 8,8% rate of postoperative complications from 20 0% ± 6,32 (% ± m) to 14,7% ± 6,07 and mortality from 27,5% ± 7,06 to 23,5% ± 7,27.