Krilyuk V. Emergency medical services and the tactics of surgical treatment in patients with trauma of the abdominal cavity with polytrauma (clinical and experimental research)

The thesis presents the results of experimental and clinical research. In the experimental part of the paper, the features of intestinal dysfunction and the influence of early fluid therapy in a model of severe combined trauma of the abdominal cavity. Past studies have revealed fundamental mechanisms that underlie the development of multiple organ dysfunction and role in that process intestine. It is shown that it is formed in the tissues of the intestine changes in the future is the trigger of dysfunction in liver tissues, lungs and kidneys. The positive role of early fluid therapy combined with solutions that prevent the development of organ dysfunction was demonstrated. In the prehospital studied the structure of preventive deaths suffered an injury of the abdominal cavity, the volume of emergency medical care and the most important factors that influence the occurrence of fatal consequences. In early hospital stage based on the results of the pilot study was examined the development of intestinal failure in affected and found that abdominal perfusion pressure is of important diagnostic criterion. To optimize the surgical treatment revealed important factors of fatal outcome, have been integrated into prognostic scale. Their use helped to clearly identify the stages of surgical treatment «damage control», which had a positive impact on the final outcome.