FAST-PROTOCOL AND INTERVENTIONAL SONOGRAPHY IN THE DIAGNOSTIC AND TREATMENT OF COMBAT INJURIES OF THE ABDOMEN
Summary. The aim — improvement of diagnostic and surgical treatment of wounded abdominal injuries by introducing emergency ultrasound techniques and mini-invasive surgery under the control of ultrasound imaging.
Materials and methods. A clinical and statistical analysis of the results of surgical treatment of 293 wounded with combat injuries of the abdomen who underwent treatment in military mobile hospitals was carried out. In the comparison of the wounded with combat injuries of the abdomen, additional diagnostic tests were carried out in the comparison groups — FAST protocol, puncture sanitation and draining surgical interventions under ultrasound navigation.
Results and discussion. In the main group, unlike the control group, all wounded were followed by the FAST protocol. Widespread introduction into the diagnostic program of FAST-protocol and diagnostic punctures under ultrasound navigation allows to reduce the level of more traumatic diagnostic laparocentheses from 24.7 to 2.2 % and unreasonable surgical interventions from 3.2 to 0.7 %. Based on the results of the study, we have developed an algorithm for diagnostic and therapeutic actions for the wounded with combat trauma to the abdomen according to the results of the FAST-protocol.
Conclusions. The data obtained indicate that the widespread adoption of the FAST protocol, transcutaneous puncture sanitation interventions under ultrasound guidance in the diagnosis and treatment of combat abdominal trauma and its complications contribute to a decrease in the number of invasive and more traumatic (often unreasonable) diagnostic and treatment methods, which leads to faster recovery and shortened treatment time.
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