Khirurgiia
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Results of surgical treatment of 156 patients with cervical vessels injuries over 10-year period were analyzed. The majority of the wounds (82.7%) located in zone II of the neck. There were 143 (91.7%) stab-knife and 12 (7.7%) shotgun wounds. ⋯ Detailed physical examination permits to avoid special device examinations before surgery in the majority of cases. When injuries of the esophagus or respiratory tract were suspected, the patients underwent diagnostic esophago- and bronchoscopy before and during surgery. Diagnostic and therapeutic policies in these kinds of injuries are systematized.
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Analysis of 102 cases of coagulated hemothorax (CH) are presented: 32--after penetrating wounds and 70--after closed chest injury. In 57% patients with chest wounds and 72% patients with closed injury the cause of CH was to applying late for medical care. ⋯ Depending on the patients state severity, CH volume and stage of it formation conservative treatment, streptase administration, thoracoscopy and thoracotomy with pleurectomy and lung decortication were performed. Lethality was 2.9%.
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A mathematical method based on a complex of capillary blood examinations was proposed and tested for detection of volume and degree of blood loss in trauma of the chest and the abdomen. This method may be used for optimization of intraoperative fluid management. It is very important when bleeding is not only into the serous cavities (blood loss is easy to evaluate during surgery) but also into the intermuscular and interstitial spaces, and also in internal hemorrhage.