ko'chada piyoz uchastkasi

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slayd 1 bosh miya jaroxati birinchi yordamni kursatirsh transportirovka transportirovka turlari transportirovka davomida vital funktsiyalar faoliyatini yukotmaslik gospitalizatsiyaga kursatmalar kursatilganlarning xoxlagan biri: es-xushning buzilishi (shkg < 15) kalla suyagi asosining sinishi simptomlari, kalla cuyagi chizikli yoki botib sinishi kup marotoba kusish uchokli nevrologik simptomatika epileptik tutkanok bmj va boshka a'zolar jaroxati jaroxat ogirligini aniklashdagi liyinchiliklar (alkogol intoksikatsiya, chakaloklar va keksalar) bolani ota-onasi tomonidan urilganga shubxalanish bosh miya jaroxati va somatik patologiya obyazatelnoe isklyuchenie sleduyushix sostoyaniy intoksikatsiya ispolzovanie mishechnix relaksantov i sedativnix preparatov pervichnaya gipotermiya gipovolemicheskiy shok metabolicheskaya koma endokrinnaya koma entsefalit stvolovoy lokalizatsii neyromishechnaya blokada lechebno-diagnosticheskie meropriyatiya pri postuplenii postradavshego v statsionar otsenka jiznenno-vajnix funktsiy i reanimatsionnie meropriyatiya otsenka xaraktera i tyajesti sochetannix povrejdeniy (organov grudnoy kletki, bryushnoy polosti, taza, povrejdeniya kostey) otsenka nevrologicheskogo statusa (kolichestvennaya otsenka sostoyaniya soznaniya, osnovnix ochagovix, obshemozgovix i dislokatsionnix simptomov) otsenka osnovnix laboratornix pokazateley pokazaniya dlya neotlojnoy neyroxirurgicheskoy konsultatsii: lyuboe iz perechislennix: koma (shkg < …

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okazaniya k rentgenografii cherepa: lyuboe iz perechislennix: poterya soznaniya v anamneze posttravmaticheskaya amneziya rana skalpa otsutstvie polnoy orientatsii i urovnya soznaniya (shkg < 15) nevrologicheskaya simptomatika rvota likvorreya ili krov iz nosa i ushey deformatsiya cherepa alkogolnaya intoksikatsiya pokazaniya k provedeniyu kompyuternoy tomografii (kt) u bolnogo s chmt: lyuboe iz perechislennix: koma, soxranyayushayasya posle provedeniya reanimatsionnix meropriyatiy shkg < 15 + perelom cherepa ochagovaya nevrologicheskaya simptomatika + perelom cherepa epilepticheskiy pripadok + perelom cherepa poyavlenie ochagovix nevrologicheskix simptomov bez komi anizokoriya simptom kushinga (urejenie pulsa i rost ad) uxudshenie urovnya soznaniya (snijenie ballov po shkg< 13) pri normalnom ad i ro₂ narushenie soznaniya (shkg < 15), dlyasheesya bolee 8 chasov postoyannaya rvota, povtornaya rvota posle chmt cherepno-mozgovaya travma sostoyanie vozduxoprovodnix putey dixanie pokazaniya k intubatsii: bolnoy ne v sostoyanii samostoyatelno podderjivat proxodimost verxnix vozduxoprovodyashix putey; neadekvatnaya ventilyatsiya; snijenie glotochnix refleksov (predraspolagaet k aspiratsii); koma (shkg < 8 ballov). konservativnoe lechenie …

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i dnem) v posleduyushem – nootropil, piriditol i drugie nootropi. intensivnaya terapiya tsel, sostavlyayushie i komponenti intensivnoy terapii v ostrom periode chmt obespechenie svobodnoy proxodimosti dixatelnix putey intubatsiya – nazotraxealnaya, orotraxealnaya traxeostomiya sanatsiya traxeobronxialnogo dereva preduprejdenie i lechenie shoka bistraya ostanovka krovotecheniya. nalojenie transportnix i improvizirovannix shin obezbolivanie oblasti pereloma vvedeniem analgetikov. sogrevanie i utolenie jajdi goryachim pitem. shadyashaya transportirovka. kompleksnie meropriyatiya pri lechenii postradavshix v sostoyanii shoka obezbolivanie oblasti pereloma. okonchatelnaya ostanovka krovotecheniya. vospolnenie krovopoteri. vosstanovlenie funktsii dixaniya. vvedenie serdechno-sosudistix sredstv. sogrevanie bolnogo. po jiznennim pokazaniyam – operativnie vmeshatelstva. pri terminalnix sostoyaniyax – kompleks reanimatsionnix meropriyatiy. cherepno-mozgovie: vospalitelnie: posttravmaticheskiy meningit posttravmaticheskiy meningoentsefalit posttravmaticheskiy ventrikulit posttravmaticheskie empiemi posttravmaticheskiy abstsess posttravmaticheskiy flebit posttravmaticheskiy osteomielit posttravmaticheskie oslojneniya so storoni myagkix pokrovov golovi (nagnoenie ran, podkojnie flegmoni, abstsessi i dr.) prochie: posttravmaticheskaya granulema, posttravmaticheskie trombozi sinusov i ven, otsrochennie narusheniya mozgovogo krovoobrasheniya, nekroz kostey cherepa i myagkix pokrovov golovi i t.d. osnovnie napravleniya …

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otsirkulyatsii – vajneyshiy faktor, opredelyayushiy effektivnost prochix lechebnix meropriyatiy: uluchshenie reologicheskix svoystv krovi – povishenie ee tekuchesti, snijenie agregatsionnoy sposobnosti formennix elementov dostigaetsya vnutrivennimi kapelnimi vlivaniyami reopolglyukina, rastvora albumina, vvedeniem kavintona, proizvodnix ksantina (eufillin, teonikol). pri nalichii subaraxnoidalnogo krovoizliyaniya - gemostaticheskaya antifermentnaya terapiya: 5% rastvor aminokapronovoy kisloti, kontrikal, trasilol, gordoks vnutrivenno po 25-20 tis. ed 2-3 raza v sut. sroki prebivaniya v statsionare bolnix s netyajelimi ushibami mozga pri neoslojnennom techenii - 21 sut. obyazatelna protivosudorojnaya terapiya - 6-12 mes. posle chmt. dozirovka preparatov (karbamzepin, paglyuferal) - v zavisimosti ot xaraktera povrejdeniya mozga, dannix eeg. lechebno-vosstanovitelniy kompleks - metabolicheskaya terapiya (nootropi, tserebrolizin), preparati, uluchshayushie tserebralnuyu mikrotsirkulyatsiyu (kavinton, tsinnarizin). osnovnie napravleniya kl pri ushibe mozga tyajeloy stepeni i ostrom travmaticheskom ego sdavlenii napravleniya lechebnix vozdeystviy dlya korrektsii narusheniy tserebralnoy mikrotsirkulyatsii: vnutrisosudistie vliyaniya – uluchshenie reologicheskix svoystv krovi, podderjanie vnutrisosudistogo davleniya; normalizatsiya sosudistogo tonusa, kontroliruemaya giperventilyatsiya, ispolzovanie vazoaktivnix preparatov; ustranenie perivaskulyarnogo oteka …

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baricheskaya oksigenatsiya, primenenie antioksidantov. diffuznoe aksonalnoe povrejdenie golovnogo mozga bolnim s dap ne trebuetsya xirurgicheskogo lecheniya, t.k. otsutstvuet substrat, podlejashiy udaleniyu. oni nujdayutsya v provedenii dlitelnoy ivl v rejime umerennoy giperventilyatsii, komplekse intensivnoy terapii, kotoraya vklyuchaet: primenenie nootropnix i vazoaktivnix preparatov, podderjanie obmennix protsessov s ispolzovaniem enteralnogo (zondovogo) i parenteralnogo pitaniya, korrektsiyu narusheniy kshs i vodno-elektrolitnogo balansa, normalizatsiyu osmoticheskogo i kolloidnogo davleniya, sistemi gomeostaza. pokazaniya k operativnomu vmeshatelstvu pri chmt: otkritaya cherepno-mozgovaya travma (est istechenie smj): vdavlenniy perelom s razrivom tverdoy mozgovoy obolochki: operatsiya trebuetsya vsegda perelom peredney cherepnoy yamki s rinoreey dlitelnostyu bolee 1 nedeli perelom sredney cherepnoy yamki (kamenistoy chasti visochnoy kosti) s povrejdeniem barabannoy pereponki i otoreey: operatsiya trebuetsya v sluchae, esli otoreya prodoljaetsya bolee 1 nedeli vozdux intrakranialno na rentgenogrammax i kt (risk vosxodyashey infektsii) ognestrelnoe ranenie golovi zakritaya cherepno-mozgovaya travma (net istecheniya smj): vdavlenniy perelom bez nadriva tverdoy mozgovoy obolochki i rani skalpa: operatsiya trebuetsya …

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slayd 1 bosh miya jaroxati birinchi yordamni kursatirsh transportirovka transportirovka turlari transportirovka davomida vital funktsiyalar faoliyatini yukotmaslik gospitalizatsiyaga kursatmalar kursatilganlarning xoxlagan biri: es-xushning buzilishi (shkg < 15) kalla suyagi asosining sinishi simptomlari, kalla cuyagi chizikli yoki botib sinishi kup marotoba kusish uchokli nevrologik simptomatika epileptik tutkanok bmj va boshka a'zolar jaroxati jaroxat ogirligini aniklashdagi liyinchiliklar (alkogol intoksikatsiya, chakaloklar va keksalar) bolani ota-onasi tomonidan urilganga shubxalanish bosh miya jaroxati va somatik patologiya obyazatelnoe isklyuchenie sleduyushix sostoyaniy intoksikatsiya ispolzovanie mishechnix relaksantov i sedativnix preparatov pervichnaya gipotermiya gipovolemiches...

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