DIAGNOSTIC AND INTERVENTIONAL SONOGRAPHY IN THE TREATMENT OF COMBAT INJURIES OF THE ABDOMEN

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 402 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%. The use of ultrasonic navigation allows to increase by 14.9% the frequency of differentiation and removal of foreign bodies — spheres and splinters at the initial surgical treatment of a wound. The use of punctures, drainage and rehabilitation of pathological cells under ultrasound navigation allowed to reduce the number of traditional and more traumatic surgical interventions by 46.9%, which in turn reduces the number of postoperative complications. The proposed mini-invasive methods of surgical treatment under ultrasound navigation of purulent-destructive complications showed high efficiency in the treatment of wounded with combat abdominal trauma — namely 90.6%.

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.