rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2012-4-88rmt-1388Research ArticleФУНДАМЕНТАЛЬНЫЕ ОСНОВЫ АНЕСТЕЗИОЛОГИИ-РЕАНИМАТОЛОГИИFUNDAMENTALS OF ANESTHESIOLOGY AND REANIMATOLOGYОсобенности течения критических состояний у шахтеровThe Specific Features of the Course of Critical Conditions in MinersМорозВ. В.MorozV. V.ЧурляевЮ. А.ChurlyaevYu. A.chur15@yandex.ruКанС. Л.KanS. L.20122606201484Том VIII № 4 2012 г.8888Copyright © Мороз В.В., Чурляев Ю.А., Кан С.Л., 20122012Мороз В.В., Чурляев Ю.А., Кан С.Л.Moroz V.V., Churlyaev Y.A., Kan S.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1388

Цель исследования — улучшение результатов лечения шахтеров на основе изучения особенностей течения у них критических состояний, обусловленных тяжелыми травматическими повреждениями и разработки дифференцированной интенсивной терапии выявленных нарушений. Материал и методы. В рамках работы обследовано 1107 человек. Функциональное состояния центральной гемодинамики исследовано у 371 здоровых шахтеров с различным стажем подземных работ, контрольную группу составили 30 здоровых добровольцев, не работающих во вредных условиях производства. Обследовано 386 пострадавших с ТЧМТ: 218 чел. — пострадавшие без подземного стажа работы, 115 чел. — пострадавшие шахтеры с подземным стажем работы в угольной шахте более 5 лет. В контрольную группу исследования вошли 53 практически здоровых донора. Обследовано 122 пострадавших шахтера с тяжелой термотравмой. Контрольную группу составили 39 практически здоровых добровольцев. Исследования проведены у 106ти пострадавших с ОРДС на фоне тяжелой сочетанной травмы в условиях искусственной вентиляции легких. Основную группу составили 63 травмированных шахтера, в группу сравнения вошли 43 человека, не имеющие подземного стажа работы. Заключение. С увеличение продолжительности работы во вредных производственных условиях в организме шахтеров возникают донозологические изменения со стороны органов и систем организма, которые носят закономерный фазный характер, укладываются в картину общего адаптационного синдрома и обусловливают особенности течения критических состояний. Особенностями течения критических состояний, обусловленных тяжелыми травматическими повреждениями у шахтеров, являются раннее развитие и большая частота осложнений, более тяжелое течение и поздние сроки восстановления утраченных функций организма в отличие от пострадавших, не работающих во вредных условиях производства. Дифференцированная интенсивная терапия критических состояний у шахтеров при тяжелых травматических повреждениях позволяет улучшить результаты лечения и уменьшить летальность.

 

Objective: to improve treatment results in miners, by studying the specific features of the course of their critical conditions caused by severe traumatic injuries, and to develop differentiated intensive therapeutic regimens for detected abnormalities. Subjects and methods. A total of 1107 subjects were examined during the study. Central hemodynamic function was explored in 371 healthy miners with various lengths of underground mining; a control group included 30 healthy volunteers unexposed to occupational hazards. Examinations were made in 386 severe brain injury victims, including 218 victims with no length of underground work and 115 injured miners with an underground work length of more than 5 years. A control group comprised 53 apparently healthy donors. One hundred and twenty-two miners with severe thermal injury were examined. A control group consisted of 39 apparently healthy volunteers. One hundred and six victims with acute respiratory distress syndrome in the presence of severe concomitant injury were examined under mechanical ventilation. Sixty-three injured miners formed a study group; a comparison group included 43 subjects with no length of underground mining. Conclusion. Upon longer exposure to occupational hazards, the prenosological changes occur in the miners' organs and systems, which display a regular phasic pattern, fit in the picture of general adjustment syndrome, and determine the specific features of critical conditions. The peculiarities of the critical conditions caused by severe traumatic injuries in miners are the early development and high frequency of complications, the more severe course and late recovery of the body's lost functions, unlike the victims unexposed to occupational hazards. Differentiated intensive therapy for critical conditions in miners with severe traumatic injuries makes it possible to improve treatment results and to reduce death rates. 

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The authors declare that there are no conflicts of interest present.