INDICATOR ANALYSIS OF DIAGNOSIS AND TREATMENT OF POLYTRAUMA IN PATIETS WITH OBESITY

Diagnosis and treatment of polytrauma as one of the most important problems of urgent surgery. The aim of the study. To make up an analysis of the indicators of our proposed diagnostic and treatment program for combined body trauma in obese patients. Materials and methods. Clinical material was 103 patients with combined body trauma, who were on the inpatient treatment at the surgery clinic during 2003-2018. Results. The proposed "clinical route" of patients with polytrauma depends on body mass index allowed us as quickly as possible, to diagnose injuries, to determine the tactics of surgical treatment and to systematize the actions of doctors in the urgent medical care providing. The challenge of the treatment method for the patients depended on their general condition. The main task of the first variant of treatment was to reach the stable hemostasis as soon as possible, which creates the basis for the hemostatic suture. To use the tactics of laparotomy program was manda-tory in the process of surgical treatment of polytrauma, especially in case of II-III degree of obesity. The tactic of "damage control" in such patients provided greater opportunities for antispasmodic therapy, correction of acidosis and compensation of the general condition of the patient, as well as reduce the fatality rate for polytrauma obese patients 1.54 vs 1.19 (p> 0.03). In cases of abdominal compartmental syndrome, the choice of surgical treatment was superimposition of the ileostomy suspension followed by decompression of the small intestine. Conclusions. The challenge of diagnosis and treatment management should be carried out on the principle of an individual approach, depending on the BMI of the patients.