| 초록 |
Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma. |
