[自杀性及自残性胸腹部损伤的诊断与手术策略特点]
[Features of diagnostic and surgical tactics for suicidal and autoaggressive thoracic and abdominal lesions].
作者信息
Abakumov M M, Tatarinova E V, Vilk A P, Zubareva O V, Danielyan Sh N
机构信息
Sklifosovsky Research Institute for Emergency Care of Moscow Department of Healthcare, Moscow, Russia.
出版信息
Khirurgiia (Mosk). 2017(10):13-17. doi: 10.17116/hirurgia20171013-17.
AIM
To analyze diagnostic and surgical tactics for suicidal and autoaggressive thoracic and abdominal lesions.
MATERIAL AND METHODS
We have analyzed the features of emergency surgical care depending on type of patients' behavior at admission. There were 516 patients with suicidal and autoaggressive thoracic and abdominal lesions.
RESULTS AND DISCUSSION
Depressive (34%) and adequate (46%) patients were examined routinely. Inadequate (aggressive) behavior is inappropriate for instrumental examination while medical sedation may be followed by significant hemodynamic disorders in patients with severe lesions. It was noted that indications for explorative surgery should be expanded in these patients and administration of sedatives should be combined with induction of general anesthesia.
CONCLUSION
Severity of trauma and type of surgery affect mental state dynamics while the kind of psychopathy influences postoperative period course.
目的
分析自杀性及自残性胸腹部损伤的诊断和手术策略。
材料与方法
我们根据患者入院时的行为类型分析了急诊外科治疗的特点。共有516例自杀性及自残性胸腹部损伤患者。
结果与讨论
对抑郁型（34%）和正常型（46%）患者进行常规检查。不适当（攻击型）行为不适合进行器械检查，而对于严重损伤患者，药物镇静可能会导致显著的血流动力学紊乱。值得注意的是，对于这些患者，探查手术的指征应扩大，镇静剂的使用应与全身麻醉诱导相结合。
结论
创伤严重程度和手术类型影响精神状态变化，而精神病变类型影响术后病程。
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