SU1691741A1 - Method for prognostication of hemorrhagic complications secondary to traumatosis - Google Patents

Abstract

The invention relates to medicine, specifically to resuscitation, traumatology, and can be used to predict hemorrhagic complications in the early post shock period. The aim of the invention is to increase accuracy and reduce complications. The goal is achieved by the fact that in a patient with a traumatic shock, an electrocoagulogram of blood is recorded and, with hypocoagulation within 10-15 minutes or more and fibrinolysis with an amplitude above 1.5, a high degree of risk of hemorrhagic complications is noted. The method is accurate, it makes it possible to reduce the production of complications from € 0 to 20%, is informative and fast in execution. 1 tab.

Description

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The invention relates to medicine, namely to resuscitation, traumatology, and can be used to predict hemorrhagic complications in the early post-shock period.

The aim of the invention is to improve the accuracy of the forecast, reducing the complications of traumatic disease.

This goal is achieved by the fact that in a known method, including the study of biochemical blood parameters, the distinguishing features are. that in a patient with a traumatic shock, an electrocoagulogram of blood is recorded and, with hypocoagulation within 10-15 minutes or more and fibrinolysis with an amplitude of more than 1.5, a high degree of risk of hemorrhagic complications is noted.

The method is carried out as follows.

After the patient is admitted to the hospital, even before the start of intensive shock therapy, blood is taken from the vein in an amount necessary to fill the electrosurgical coagulograph container. and after installing the container in the H-334 unit, the first recording of the electrocoagulogram was made. The study was conducted with. at intervals of 3-4 times on the first day, the control is carried out once for 3-4 days. If, at least once, hypocoagulation within 10–15 min or more and fibrinolysis with an amplitude of more than 1.5 were found on the electrocoagulogram. These patients, even in the absence of clinical manifestations of bleeding, are at risk of developing hemorrhagic complications in the post-shock period.

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Periodically, which was subsequently confirmed by a significant percentage of observations with clinical manifestations in the form of acutely developing profuse gastrointestinal, nasal and wound hemorrhages.

The method is illustrated by the following examples:

PRI me R 1. Patient K., 58 years old. He entered on 13/10/86 with a diagnosis of injury to the occipital region, closed fracture of the left femur without displacement. Traumatic shock I degree. Six hours after admission to the electrocoagulogram, hypocoagulation was recorded within 15 min and fibrinolysis with an amplitude of 1.8. The clinical condition of the patient is of moderate severity. On the third day after admission, there is a lethal outcome on the background of acute, developed profuse gastrointestinal bleeding.

PRI mme R 2. Patient G., 25 years old. He entered on 01/29/87, with a diagnosis of an open fracture of the right humerus in the middle third with displacement, a closed fracture of the left humerus in the middle third with displacement, a closed fracture of the left scapula, a scalped wound in the area of the scapula. Traumatic shock II degree. Immediately upon admission to the electro-coagulogram, hypocoagulation was registered - 10 minutes and fibrinolysis amplitude 1.5. 5 days after the injury, sudden massive bleeding from a wound on the scapula developed. Bleeding managed to stop. The patient was discharged with improvement.

Example 3: Patient V., 17 years old, was taken by ambulance with a diagnosis of traumatic amputation of the middle third of the right hip and l of rheumatic shock, grade II. On admission from the right subclavian vein of the blood, an elecrocoagulogram was recorded. Hypocoagulation of i4 30 and fibrmolysis with an amplitude of 1.5 was registered. Transfuse 1 l blood of freshly single-group donor blood. After 6 h, the indicators returned to normal. The post-shock period went smoothly.

Example4. Patient A., aged 27, entered

diagnosed with open comminuted fracture of the pelvic bones with displacement of fragments, rupture of the perineum, rupture of the bladder. Traumatic shock III degree. 6 h after injury on the electrocoagulogram, hypocoagulation 13 and fibrinolysis 1.5. Perelito 800 ml of freshly-parinized single-group donor blood. After 12 hours

coagulation and fibrinolysis returned to normal. The postoperative period is safe.

The advantage of the proposed method is that it makes it possible to predict the development of severe hemorrhagic complications of the early post-shock period using a simple, reliable and affordable rapid method and to carry out timely prevention. Forecasting has reduced the percentage of complications, as illustrated by the data in the table.

The method may be of particular importance in extreme conditions, since the implementation of the technique requires simple and compact equipment, and to obtain information - no more than 30 minutes.

Claims (1)

Formula for the invention A method for predicting hemorrhagic complications in a traumatic disease, including an analysis of blood coagulation factors, characterized in that, in order to improve the accuracy of the method and reduce complications, an electro-coagulogram is recorded before the onset of intensive therapy and during hypocoagulation for 10-15 minutes, and fibrinolysis is more 1.5 predict the development of complications.