Сучасні технології в діагностиці та визначенні лікувальної тактики у дітей із закритою травмою паренхіматозних органів черевної порожнини

Клінічні, лабораторні та інструментальні критерії визначення тяжкості ураження печінки та селезінки у дітей із закритою абдомінальною травмою. Особливості диференційованого лікування в залежності від ураження паренхіматозних органів черевної порожнини.

Рубрика Медицина
Вид автореферат
Язык украинский
Дата добавления 27.07.2015
Размер файла 1,3 M

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Summary

Korynevska I.M. Modern technologies in diagnostic and determination of management tactic in children with blunt trauma of solid abdominal organs. - Manuscript.

Thesis for a PhD degree in speciality 14.01.09 - pediatric surgery. - Olexandr Bohomolets National Medical University, Kyiv, 2010.

The results of diagnostic and management of 177 children with blunt abdominal trauma were analyzed.

The bruise of the abdominal wall was in 121 (68.4%) patients and in 56 (31.6%) - injury of solid organs of abdomen were established. The trauma of spleen was identified in 28 (50%), trauma of liver - in 21 (37.5%) and trauma of pancreas - in 7 (12.5%) children.

Age and sex structure of children with blunt abdominal trauma, dependence of injury from causes of trauma were analyzed.

Prognostic value of clinical, laboratory data and results of instrumental diagnostic methods about severity of solid organ injury were determined.

A complex evaluation of the results of this investigation in diagnostics of injuries severity was proved. It was confirmed, that ultrasonography (as non-invasive) and laparoscopy (as invasive) are highly sensitivity methods of diagnostic.

The determination of management tactic in children with isolated blunt trauma of solid abdominal organs depends on the hemodynamic stability and data of instrumental methods of investigation.

Algorithms of diagnostic and management of children with blunt abdominal trauma were improved.

Differentiated approach for conventional treatment, laparotomy and laparoscopy were proposed. Conventional therapy in children with solid organ injury of I-II level (classification of AAST) with stable laboratory and sonography monitoring was settled. It was confirmed, that the hеmodynamic instability is decisive for determination of operative tactic of treatment. It was proved, that laparascopy method is highly effective in diagnostic and treatment. Laparoscopy was used in children with solid organ injury of II-III level. It was determined, that laparoscopy is more advanced than laparatomy.

Key words: blunt trauma, spleen, liver, pancreas, diagnostic, conventional treatment, laparotomy, laparoscopy, children.

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