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9ABOUT THE CAUSES OF HEAD AND NECK INJURIES IN CHILDREN
Shamsiev A.
Samarkand State Medical Institute Department of pediatric surgery №1, MD, DSc, professor
Atakulov J. Samarkand State Medical Institute Department of pediatric surgery №1, MD, DSc, professor
Rakhimov A.
Samarkand State Medical Institute Department of pediatric surgery №1, assistant
Baymuradov N. Samarkand State Medical Institute Department of pediatric surgery №1, PhD, docent
Shamsiev R. Samarkand State Medical Institute 2-year student of faculty of medical pedagogy Samarkand, Republic of Uzbekistan
Abstract
Head and neck injuries are quite common in any large-scale man-made accident, pet attacks or as a result of catatrauma, as a result of which an emergency surgical intervention is carried out for this pathology. In the 2 -clinic of SamMI in the period from 2013 to 2020, 273 patients with various injuries of the head and neck were treated. In more than half of the cases, the cause of the injury was a fall from a height and the collapse of objects, materials and earth on the victim-156 (57.1%), slightly less often injuries occurred due to contact with animals - 45 (16.5%) or exposure to various moving, flying objects and parts - 44 (16.0%). It should be noted that in 28 (10.2%) the cause of the injury was a traffic accident. Of all 273 patients, 74 (27.0%) needed outpatient care, and after initial surgical treatment, they were discharged home under the supervision of a pediatric surgeon at the place of residence. In other cases, the victims, taking into account the severity of the injury, were hospitalized. Combined trauma was diagnosed in 55 (20.1%) cases. In this category of patients, treatment tactics were carried out jointly with specialists of related specialties: neurosurgeons, traumatologists, neuropathologists. Mortality in this category of patients was noted in 14 (5.1%).
Keywords: pediatric surgery, head, neck, trauma.
Relevance. The technological development of civilization contributes not only to an increase in the number of victims with head and neck injuries, but also to the aggravation of the injury itself [2; 3]. Recent statistics show that the problem of traumatic brain injury (TBI) has long been a social problem [1; 4]. TBI is the leader among injuries of all localizations in terms of the specific weight in disability and mortality of the population. Head and neck injuries are quite common in any large-scale man-made accident, pet attacks or as a result of catatrauma, as a result of which an emergency surgical intervention is carried out for this pathology [6]. The maximum effectiveness of treatment of victims can be achieved on the basis of fast and qualified delivery of the affected child to a specialized department, which has all the necessary conditions for providing
Causes
full-fledged medical care. The amount of medical care depends on the medical and tactical situation and is the maximum possible for a particular situation [5].
Head and neck injuries result in a range of injuries, from small cuts to life-threatening airway obstruction in children.
Purpose of the research. To analyze the results of the causes of head and neck injuries in children. Materials and methods of the research: In the
period from 2013 to 2020, 273 patients with various head and neck injuries were treated at the 2-clinic of the Samarkand Medical Institute. Of these, 116 (42.5%) were urban and 157 (57.5%) were rural. The majority of patients were male - 184 (67.5%), the average age of patients was 3-5 years. The causes of injuries are shown in table 1.
Table 1
of injuries
Cause of injury n %
Traffic accident 28 10,2
Falling from a height 58 21,3
Falling, collapsing objects, materials, earth 98 36,0
Impact of moving, flying, rotating objects and parts 44 16,0
Damage caused by contact with animals, insects and reptiles 45 16,5
Total 273 100
As can be seen from the above table, in more than half of the cases, the cause of injury was a fall from a height and the collapse of objects, materials and earth on the victim-156 (57.1%), slightly less often injuries occurred due to contact with animals - 45 (16.5%) or exposure to various moving, flying objects and parts -44 (16.0%). It should be noted that in 28 (10.2%) the cause of the injury was a traffic accident.
Combined
Results of the research and their discussion. Of
all 273 patients, 74 (27.0%) needed outpatient care, and after initial surgical treatment, they were discharged home under the supervision of a pediatric surgeon at the place of residence. In other cases, the victims, taking into account the severity of the injury, were hospitalized in a hospital. Combined trauma was diagnosed in 55 (20.1%) cases (Table 2).
Table 2
injuries
Type of injury n %
Moderate brain injury 35 62,0
Fracture of the bones of the base of the skull 5 9,1
Brain contusions may be combined with subdural hematoma 2 3,6
Epidural hematoma 1 1,8
Subarachnoid hemorrhage combined with multiple rib fractures 1 1,8
Severe brain injury 3 5,4
Brain smashing 1 1,8
Intracerebral hematoma 8 14,5
Fractures of the bones of the upper limb 4 7,2
Fractures of the bones of the lower limb 7 12,7
Fractures of the trunk bones 3 5,4
According to Table 2, of the combined injuries, a moderate brain contusion was more often diagnosed -35 (62.0%), a severe brain contusion was noted in 3 (5.4%) patients, and an intracerebral hematoma was detected in 8 (14.5%). Various fractures of the bones of the body were often diagnosed (fractures of the bones of the upper limb-7.2%, fractures of the bones of the lower limb-12.7%, fractures of the bones of the trunk -5.4%). In this category of patients, treatment tactics were carried out jointly with specialists of related specialties: neurosurgeons, traumatologists, neuropathologists. Mortality in this category of patients was noted in 14 (5.1%). The causes of death were combined injuries associated with the involvement of the skull bones and brain matter in the pathological process: in 8 (2.9%), the cause was an intracerebral hematoma, in 5 (1.8%), a fracture of the base of the skull, and in 1 (0.4%), a brain fracture.
Conclusions. Thus, children who have received injuries of various localization require immediate treatment in a specialized pediatric surgical hospital, where, after examination and examination, further treatment tactics are developed. Examination and treatment, if necessary, should be carried out with specialists of related specialties.
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