Novosti
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Year 2014 Vol. 22 No 3
PEDIATRIC SURGERY
V.V. MASLYAKOV1, A.J. DADAEV2, A.Z. KERIMOV2, K.G. KURKIN1
THE IMMEDIATE TREATMENT RESULTS OF THORACIC GUNSHOT INJURY IN CHILDREN
NSEE HPE "Saratov Medical Institute «Reaviz»”1,
FSBEE HPE “Chechen State University” 2, Grozny,
The Russian Federation
Objectives. To study the immediate treatment results of thoracic gunshot injury in children received during the local conflict in the Chechen Republic.
Methods. The analysis of the immediate treatment results of thoracic gunshot injury in 34 children has been carried out. The non-penetrating wounds were detected in 6 children. The victims with penetrating wounds (28 patients) were allocated into two groups. In the first group 21 (75%) patients were enrolled hospitalized during the first hour after an injury. In the second group 7 (25%) victims delivered more over than in one hour after an injury (1,5-8 hours) were enrolled.
Results. Complications in the first group of patients in the nearest postoperative period developed in 9 (42,8%) cases. The main complications: pneumonia and festering of the postoperative wound have been registered in 7 (33,3%) cases. In the nearest postoperative period 6 (28,5%) children died. Causes of death were: hemorrhagic shock – in 2 (9,5%) cases, traumatic shock – in 2 (9,5%), heart tamponade – in 1 (4,7%), sepsis – in 1 (4,7%). In the second group the complications developed in all cases. The main complication was pneumonia which developed in 6 (85,7%) patients. Rethoracotomy was performed in 2 (28,5%) patients with the lungs collapse and empyema. In this group 4 (57,1%) victims died. The cause of death was acute blood loss, hemorrhagic shock – 3 (42,8%) cases and septic shock – 1 (14,2%) case. The treatment and diagnostic algorithm in children with the thoracic gunshot injury have been worked out and it includes the following: pain relief, restoration of the airways passability, puncture or (as it required) adequate drainage of the pleural cavity, cessation of bleeding and reinfusion, infusional, antibacterial and symptomatic therapy.
Conclusions. Treatment results of the thoracic gunshot injury in children depend on the terms of delivery. In case of delivery during the first hours the complications develop in 42,8%, lethality – 28,5%. In case of delivery after more than 1,5 hours complications develop in 100% of cases, lethality makes up 57,1%.
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410012, Rossiyskaya Federatsiya, g. Saratov, ul. Verhniy ryinok, korpus 10, NOU VPO «Saratovskiy meditsinskiy institut «REAVIZ», kafedra klinicheskoy meditsinyi,
e-mail: maslyakov@inbox.ru,
Maslyakov Vladimir Vladimirovich
Maslyakov V.V. MD, professor Vice Rector for research and public relations, a head of the clinical medicine chair of NSEE HPE “Saratov Medical Institute «REAVIZ»”.
Dadaev A.J. MD, a head of the hospital surgery chair of FSBEE HPE “Chechen State University”, Grozny.
Kerimov A.Z. PhD, an associate professor of FSBEE HPE “Chechen State University”, Grozny.
Kurkin K.G. A post-graduate student of the clinical medicine chair of NSEE HPE “Saratov Medical Institute «REAVIZ»”.
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