[The characteristics of the diagnosis, intensive therapy and surgical procedure in contusions of the heart].
Based on an analysis of results of treatment of 86 patients and wounded with severe combined traumas and gunshot wounds the authors have made a diagnostic scale including 8 most significant symptoms of heart contusions which determine the index MS-HC (military surgery-heart contusion). The value of this index in scores gives a reliable picture of heart contusion. Patients having not less than 15 scores are considered to be in a critical state. Lethality among them was 80%, the survivors had complications in 45% of the cases. The autopsy showed that the diagnosis of heart contusion by the score system was correct and coincided with the autopsy findings in 94.7%. A rational program of intensive therapy for heart contusions is proposed aimed at the maintenance and development of compensatory abilities in the hemodynamic system. The basic drugs are thought to be nitroglycerin, dobutrex (dophamin), neoton. The rational surgical policy for injuries of different areas of the body, terms of its realization, indications related with different degrees of the patient's state are determined. The realization of these approaches to treatment of wounds and traumas involving contusions of the heart made lethality of such patients 27% less.
Gumanenko
E K
EK
Gavrilin
S V
SV
Boiarintsev
V V
VV
Kuz'min
A Ia
AIa
D000465:Algorithms; D006348:Cardiac Surgical Procedures; D003131:Combined Modality Therapy; D003288:Contusions / Q000175:diagnosis* / Q000628:therapy; D003422:Critical Care / Q000379:methods*; D003951:Diagnostic Errors; D004630:Emergencies; D006335:Heart Injuries / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D009104:Multiple Trauma / Q000175:diagnosis / Q000628:therapy; D015599:Trauma Severity Indices; D016896:Treatment Outcome
Osobennosti diagnostiki, intensivnoĭ terapii i khirurgicheskoĭ taktiki pri ushibakh serdtsa.