DYNAMICS OF CLINICOLABORATORY CHANGES IN SUFFERERS WITH MULTIPLE AND ASSOCIATED LOCOMOTOR SYSTEM INJURIES

Abstract

Aim. To study the dynamics of pain syndrome, blood lactate, stress level and vegetative dysfunction in sufferers with multiple and associated injuries of the locomotor system. Materials and methods. Fifty six sufferers including 37 men and 19 women were investigated. Two groups were formed: group 1 - multiple locomotor system injuries in 30 patients; group 2 - locomotor system injuries associated with mild craniocerebral injury in 26 patients. Pain syndrome manifestation was studied by visual analogue scale for pain (VAS), stress level (SL) and Kerdo index (KI). Venous blood lactate concentration was determined. Results. Pain, autonomous reflectory or circulatory changes connected with it, led to formation of hypoxia, vegetative nervous system dysfunction. Severe vegetative disorders were usually detected in complex injuries, creating increased difficulties in reposition and fixation of fragments. Qualitative reposition of bone fragments was an adequate way for prevention of vegetative disturbances in severe locomotor system injury. It is necessary to assess hypoxia manifestation, stress and vegetative dysfunction levels in case of multiple and associated injury so as to carry out rational treatment of locomotor system injuries and their complications. Conclusions. 1. Traumatic disease course in case of multiple and associated injuries is accompanied by anemia and development of hypovolemic shock. Venous blood lactate was considered as an index of adequate oxygen delivery to organs and tissues. 2. Vegetative disturbances characterized the level of adaptive opportunities of the body. When considering these injuries as a stress status, complex approach to management of treatment and rehabilitation process was developed.

Keywords

Multiple and associated locomotor system injuries / pain syndrome / blood lactate / stress level / vegetative dysfunction

References

[1] Агаджанян В. В. Политравма: перспективы исследования проблемы. Политравма 2007; 3: 5-7.

[2] Агаева К. Ф. Процесс накопления и распространения последствий травмы головы среди населения. Журнал неврологии и психиатрии им. С. С. Корсакова 2001; 5: 46-48.

[3] Бондаренко А. В., Пелеганчук В. А., Герасимова О. А. Госпитальная летальность при сочетанной травме и возможности ее снижения. Вестник травматологии и ортопедии им. Н. Н. Приорова 2004; 3: 49-52.

[4] Денисов А. С., Ладейщиков В. М., Щеколова Н. Б. Сочетанные повреждения груди и головы. М.: Медицинская книга 2008; 244.

[5] Живолупов С. А., Самарцев И. Н., Коломенцев С. В. Патогенетические механизмы травматической болезни головного мозга и основные направления их коррекции. Журнал неврологии и психиатрии им. С. С. Корсакова 2009; 10 (109): 42-46.

[6] Селезнев С. А., Багненко С. Ф., Шапот Ю. Б., Курыгин А. А. Травматическая болезнь и ее осложнения. СПб.: Политехника 2004; 426.

[7] Соколов В.А. Дорожно-транспортные травмы: руководство для врачей. М.: ГЭОТАР-Медиа 2009; 173.

[8] Устьянцева И. М. Лабораторная диагностика при политравме. Политравма 2008; 4: 51-59.

[9] Щеколова Н. Б., Ладейщиков В. М. Церебральная патология при сочетанных и множественных повреждениях. Пермский медицинский журнал 2007; 4 (24): 31-34.

[10] Щеколова Н. Б. Структура, динамика, рациональная коррекция церебральных нарушений при сочетанных и множественных повреждениях. Уральский медицинский журнал 2012; 13: 14-18.

[11] Delany H. M., Berlin A. W. Multiple trauma. New York State J. Med. 1983; 7 (83): 710-730.

[12] Mima T., Matsuoka T., Hallen M. Information flow from the sensomotor cortex to muscle in humans. Clinical Neurophysiology 2001; 1 (112): 122-126.

[13] Mogyoros S., Lin C., Dombo S. Reproducibility of indices of axonal excitability in human subjects. Clinical Neurophysiology 2000; 1 (111): 23-28.

[14] Phipps A. B., Byrne M. K. Brief intervention for secondery trauma review and recommendations J. Stress and Health 2003; 3 (19): 139-147.

[15] Regehr Ch., Hill I., Knott T. Social support, self-efficacy and trauma in recruits and experienced firefighters J. Stress and Health 2003; 19 (4): 189-193.

RIGHTS & PERMISSIONS

Schekolova N.B., Mudrova O.A., Zubareva N.S.