Balyasevich S. Combined abdominal and vertebral trauma in road accident victims

According to the WHO, up to 2 million people die in road accidents in the world every year, 20-50 million are injured and disabled. At the combined and isolated trauma of a stomach operative activity reaches 88%, considerably exceeding that at an injury of extremities, a pelvis, a breast and craniocerebral traumas. To perform the tasks of the study, we retrospectively analyzed 167 maps of an inpatient with a diagnosed abdominal-vertebral trauma, which were divided into groups according to the outcome of the traumatic disease. Clinical and epidemiological characteristics of the study indicated the prevalence of victims with abdominal and vertebral trauma as a result of road accidents aged 20-40 years (58.4%), males (49.1%) with the mechanism of trauma direct impact (79.2%) ), who took part in the movement of drivers of 4-wheeled vehicles (30.6%). Clinical and nosological characteristics of the traumatic process indicated that most often abdominal trauma was manifested by damage to parenchymal organs (59.0% in the group of dead and 35.8% of the group of recovered) and damage to hollow organs (27.8 in the group of dead and 16.1% of the group of recovered). ), spinal cord injury was most often diagnosed in the thoracic spine and adjacent vertebrae (43.9%), in the spinal cord - compression fractures of the vertebrae (28-29%). Clinically effective risks of traumatic process in victims of abdominal and vertebral trauma as a result of road accidents were found and evaluated, which revealed that the highest catastrophic level was found in men older than 71 years, and among women - up to 20 years, with unknown mechanism of trauma. pedestrians, when the border of the cervical and thoracic spine is damaged, in the cervical region - with multiple vertebral fractures, in the thoracic region - with multi-fragmentary-explosive vertebral fractures, and in the lumbar - ligament damage. A scientifically substantiated unified protocol scheme of emergency medical care for victims of abdominal and vertebral trauma as a result of an accident in the prehospital stage was developed, formed and implemented, which allowed to reduce mortality in the prehospital stage by 5.7% and increase survival by 10.2%. The proposed protocol scheme for providing emergency medical care to victims of abdominal and vertebral injuries as a result of an accident at an early hospital stage really improves the overall result of providing emergency medical care to victims of this category and reduces mortality by 5.5% and increases survival by 9.3%.