Neurosurgery

doi: 10.25005/2074-0581-2017-19-4-482-486
NEW APPROACHES TO REDUCING MORTALITY IN SEVERE COMBINED CRANIOCEREBRAL INJURY

A.A. Razzokov1, M.K. Nazarov2

1Department of Traumatology, Orthopaedics and Military Field Surgery, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
2Tursunzade Central Regional Hospital, Tursunzade, Tajikistan

Objective: The decline of the lethality in severe combined craniocerebral injury (SCCI) by implementing a program of diagnosis and treatment of fat embolic syndrome (FES) identification methods.

Methods: Analyzed data on 338 patients with SCCI at the age of 18 to 68 years, which depending on the diagnosis and treatment tactics distributed to the control group (42.6%) and the main group (57.4%). Treatment of patients of the control group carried out traditionally, and in the main group – taking into account the results of identification of fat globulemia and neuroimaging data.

Results: Common to both groups of patients were signs arising from the overlap of symptoms of FES and craniocerebral trauma – and other impaired consciousness, hypoxia, etc. In the main group, FES diagnosed in 33 (17.0%) patients, in 99 (51.0 %) – craniocerebral trauma and in 62 (32.0%) – their combination. In general, in the main group, clinical manifestations of FES detected in 95 (49.0%) patients, including 12 (12.6%) in the classical, 9 (9.5%) – clinical, 31 (32.6%) – subclinical form, and 43 (45.3%) patients had no clinical manifestations of fat globulemia. Mortality in the control and main groups was 40.3% and 26.8%, respectively

Conclusions: The introduction to the system of diagnostic considered lesions of FES identification methods and neuroimaging data, as well as differentiated treatment tactics, contributed to a 13.5% decrease in mortality rate.

Keywords: Combined trauma, craniocerebral trauma, fat globulemia, fat embolic syndrome, lethality..

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Authors informations:

Razzokov Abduvali Abduhamitovich, Doctor of Medical Sciences, Full Professor, Head of the Department of Traumatology, Orthopedics and Military Field Surgery, Avicenna TSMU

Nazarov Mahmadali Kadyralievich, Head of the Neurosurgical Department of the Tursunzade Central Regional Hospital

Address for correspondence:

Razzokov Abduvali Abduhamitovich

Doctor of Medical Sciences, Full Professor, Head of the Department of Traumatology, Orthopedics and Military Field Surgery, Avicenna TSMU

734003, Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: (+992) 915 046001

E-mail: rfiruz@mail.ru

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