Tula, Tula, Russian Federation
Russian Federation
UDK 61 Медицина. Охрана здоровья
Na segodnyashniy den' yavlyaetsya aktual'nym vopros stress-inducirovannoy giperglikemii s razvitiem tyazhelyh ostryh serdechno-sosudistyh oslozhneniy. Proveden analiz letal'nyh ishodov pacientov, postupivshih po linii SMP v reanimacionnoe otdelenie TOKB №2 im.L.N.Tolstogo za 2014-2018gg. Vsego za 5 let umerli 141 chelovek. Vse pacienty postupali v krayne tyazhelom sostoyanii v otdelenie reanimacii TOKB №2, gde provodilas' intensivnaya insulinoterapiya, antibiotikoterapiya, kislorodoterapiya, regidratacionnaya, neyroprotektivnaya, antikoagulyantnaya, dezintoksikacionnaya, simptomaticheskaya terapiya, dinamicheskiy kontrol' zhiznennyh pokazateley: ChSS, AD, pul's, SpO2, EKG, kontrol' pokazateley uglevodnogo obmena, biohimicheskogo analiza krovi, obschego analiza mochi, acetona mochi, koagulogrammy. 23,4% vseh postupivshih bol'nyh za ukazannyy pyatiletniy period ne imeli v anamneze ukazaniy na nalichie saharnogo diabeta, 13,5% bol'nyh byli dostavleny v sostoyanii alkogol'nogo op'yaneniya i alkogol'noy intoksikacii. Sredi osnovnyh prichin smerti pacientov byli takie, kak ostryy infarkt miokarda, ostroe narushenie mozgovogo krovoobrascheniya, alkogol'nyy pankreatit, tromboemboliya legochnoy arterii, pankreonekroz pri saharnom diabete, sepsis, mezenterial'nyy tromboz, ostryy gnilostnyy pielonefrit, gangrenoznyy holecistit, cirroz pecheni, peritonit. V hode raboty ocenivalos' kachestvo raboty sluzhby skoroy medicinskoy pomoschi, soblyudenie pravil marshrutizacii krayne tyazhelyh bol'nyh v blizhayshie otdeleniya reanimacii, a takzhe pravil'noe opredelenie prioritetnyh simptomov osnovnogo zabolevaniya. Medicinskaya i social'naya znachimost' temy stressinducirovannoy giperglikemii ne vyzyvaet somneniy, t.k. diagnostika i lechenie ee pozvolit osuschestvit' svoevremennuyu profil'nuyu gospitalizaciyu bol'nyh po osnovnomu zabolevaniyu, izbezhat' giperdiagnostiki saharnogo diabeta i dopolnitel'nyh finansovyh zatrat v otdelenii intensivnoy terapii kriticheskih sostoyaniy, minimizirovat' letal'nost' i oslozhneniya interkurrentnyh zabolevaniy.
: stress-inducirovannaya giperglikemiya, gipoglikemiya, saharnyy diabet 2 tipa, serdechno-sosudistye oslozhneniya, letal'nost', sluzhba SMP.
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