Khrapov Yu V, Alekseev D E, Svistov D V
Military Hospital #413, Defense Ministry of the Russian Federation, Volgograd, Russia.
Kirov Military Medical Academy, Defense Ministry of the Russian Federation, Saint-Petersburg, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2017;81(1):108-117. doi: 10.17116/neiro2017807108-117.
Military operations in various parts of the world in the early 2000s are becoming more regionalized; new warfare tactics emerge, which makes it necessary to review and modify the neurosurgical care system. The article reviews the results of original studies on this issue and summarizes the experience of the US Army medical service in Afghanistan and Iraq. The article discusses the structure of sanitary losses, organization and scope of medical and evacuation neurosurgical measures, types and techniques of surgical interventions, and the rate of complications. We describe five levels of neurosurgical care echelons and an implemented "injury control - neurosurgery" concept; particular attention is paid to the peculiarities of research and specialist training. We demonstrate that implementation of the new concept for organization and scope of neurosurgical care has improved treatment outcomes and reduced the mortality rate in the mentioned military conflicts of recent years compared to those in the Vietnam War. We may conclude that the described experience of the US Army can be used to improve the efficacy of neurosurgical care to the wounded and victims of armed conflicts.
21世纪初，世界各地的军事行动日益呈现出地区化的特点；新的作战战术不断涌现，这使得有必要对神经外科护理系统进行审视和调整。本文回顾了关于这一问题的原创性研究成果，并总结了美国陆军医疗服务部门在阿富汗和伊拉克的经验。文章探讨了卫生减员的构成、医疗及后送神经外科措施的组织与范围、外科手术干预的类型与技术以及并发症发生率。我们描述了神经外科护理梯队的五个级别以及所实施的“损伤控制 - 神经外科”理念；特别关注了研究及专业培训的特点。我们证明，与越南战争相比，近年来在上述军事冲突中，神经外科护理组织与范围新理念的实施改善了治疗效果并降低了死亡率。我们可以得出结论，美国陆军的上述经验可用于提高对武装冲突伤员和受害者的神经外科护理效能。
