Kotov I A, Platonov Iu F
Zh Vopr Neirokhir Im N N Burdenko. 1983 Mar-Apr(2):29-32.
The frequency and character of errors in the diagnosis and treatment of 239 patients with shock mainly caused by a severe craniocerebral injury combined with other damages were studied. It was established that the percentage of diagnostic errors in these cases was quite high both in the prehospital stage and in the hospital (41 and 23%, respectively). Such injuries take o latent course, masking each other. It is shown that craniocerebral injury and blood loss have an aggravating effect on shock developing in a combined trauma. The advancing cerebral hypoxia in severe shock intensifies the affection of the brain caused by the direct trauma, which makes the diagnosis of craniocerebral and extracranial injuries very difficult. Underestimation of the severity of the developing shock leads to deficient antishock therapy.
对239例主要由严重颅脑损伤合并其他损伤所致休克患者的诊断和治疗错误的频率及特点进行了研究。结果表明，这些病例在院前阶段和医院内的诊断错误率都相当高（分别为41%和23%）。此类损伤呈隐匿病程，相互掩盖。结果表明，颅脑损伤和失血对复合伤中休克的发展有加重作用。严重休克时不断进展的脑缺氧会加剧直接创伤对脑的损害，这使得颅脑损伤和颅外损伤的诊断非常困难。对正在发展的休克严重程度估计不足会导致抗休克治疗不足。
