CC BY
10
Vestnik KazNMU №3-2018 UDC 614.2:316.346
Z.B. Abdrakhmanova, M.A. Buleshov, Y.S. Moldaliev
International Kazakh-Turkish University named after H.A. Yasavi
MEDICAL AND SOCIAL ASPECTS OF INJURIES AMONG ELDERLY AND SENILE PATIENTS
Over the past few decades, the demographic situation in the world has been characterized by a progressive increase in the number of older and older persons in the population of almost all developed countries.
Since injury is an urgent problem for the elderly, there is an urgent problem in the analysis of the causes of injuries among them with the aim of timely adoption of organizational preventive measures.
Keywords: innovative methods of treatment, elderly and senile age, trauma, trauma care, efficiency
Introduction. According to the Agency of Statistics of the Republic of Kazakhstan, our country is not an exception with regard to the number of people of elderly and senile age. In the general structure of the number of citizens, the share of the population aged 65 and over in the total population of the country is 12.9%. As of January 1, 2016, 21.8% of all women are 60 years of age or over, and only 13.4% of the total male population belongs to this age range [1].
Based on the fact that the number of older people will increase in the next few years, the number of injuries to this category of citizens will also increase.
To date, the peculiarities of acute trauma in elderly and elderly people are not paid enough attention. In the domestic and foreign literature there are only single publications devoted to private issues of trauma in the elderly. Given that in our country a significant proportion of people over 60 years of age work, this age aspect have an economic component. Over the past 10 years, the number of working pensioners in the Republic of Kazakhstan has increased by 13.0%. According to the Ministry of Labor and Social Protection, the number of working pensioners is 40.0%, about 90.0% of Kazakhstanis after retirement work for another three years, and 60.0% for another 6 years. It should be noted that treatment of elderly and elderly people is more expensive due to the increase in the duration of inpatient treatment[2,3,5]. So, proceeding from the analysis of direct costs for surgical treatment of this category of citizens on the example of the city of Shymkent, the South-Kazakhstan region, the costs are 10.0% of the annual city budget[1].
In addition, it should be noted that the outcome of injury in elderly and elderly people is much worse, and the number of complications is much higher than in people of a younger age. In the US and EU countries, despite the fact that the treatment and rehabilitation of one such patient with a fracture of the proximal femur varies in the range from 28 to 40 thousand dollars, only 25.0% of the patients recover completely[1]. The purpose of the study was to study the characteristics, severity, types of injuries in elderly and elderly patients
Table 1 - Characteristics of patients hospitalized in the traumatology care, 2014-2016_
hospitalized for the treatment of trauma in the trauma department of the Shymkent City Emergency Hospital. Material and methods.
The study was conducted on the basis of the Shymkent City Emergency Hospital in the city of Shymkent. This work is a retrospective medical-statistical and socio-hygienic study.
The analysis of the incidence of trauma and the treatment of injuries in elderly and senile patients was carried out according to the medical reports of the trauma department for 2014-2016. The analysis included data from the statistical department, reporting forms No. 14, No. 30, No. 066 / y, form No. 027 / y "Extract from the medical chart of the inpatient patient", elderly and senile patients treated at the Traumatology Department from January 1, 2014 to December 31, 2016. Data on the costs of treating individuals for nosology, the cost of one bed-day were requested in the economic department of the hospital by year. All data was processed using statistical software SPSS V.19. The results are presented as the mean ± standard error. P-value less than 0.05 was considered statistically significant. Results and Discussion.
The characteristics of injuries in the elderly hospitalized in the trauma department of the Shymkent City Emergency Hospital are presented in Table 1.
The number of patients per year was as follows: 45 (40.5%) - in
2014, 28 (25.2%) in 2015 and 38 (34.2%) in 2016.
The mean age of patients was 69.1 ± 12.9 years, 70.0 ± 7.8 years
and 72.1 ± 8.9 years in 2012, 2013, 2014, respectively.
The number of women prevailed among those hospitalized for
three years, with a greater difference in the prevalence of women
in 2013.
As can be seen from Table 1, the main mechanism of injury among the elderly is the fall in both street and home trauma, up to 62% of all injuries. After them there are accidents up to 10%, and to a lesser extent industrial and agricultural injuries to 5%.
Department of Shymkent city hospital of emergency medical
Parametrs 2014 2015 2016 Pvalue
Quantity of patients, N (%) 45 (40,5%) 28 (25,2%) 38(34,2%) 0.139
Age, M ± SD 69,1 ±12,9 70,0 ±7,8 72,1 ±8,9 0.418
Gender men 21 (46,7%) 10 (35,7%) 17(44,7%) 0.144
women 24 (53,3%) 18 (64,3%) 21(55,3%) 0.651
Mechanism of injury
Street 13 (28,9%) 7 (25,0%) 14(36,8%) 0.282
Household 28 (62,2%) 17 (60,7%) 19(50,0%) 0.200
Road accidents 4 (8,9%) 3 (10,7%) 3 (7,9%) 0.905
Production - 1 (3,6%) 2 (5,3%) 0.564
In the structure of injuries among elderly persons predominate hip fractures - 43%, followed by the patella injury, the third beam fractures in a typical place and rib fractures. Analysis of the prevalence of injuries by season showed a predominance of the winter period compared to other seasons, the second most common trauma in the summer. To analyze the effectiveness of trauma care provided to elderly and senile according casualty department of Shymkent city hospital emergency care, we conducted a comparative analysis of
the treatment of patients treated with a variety of treatments in the years 2014-2016 (conservative methods, traditional operational, operational innovation methods). In the trauma unit of Shymkent city hospital emergency care in 2014-2015 introduced the latest innovative methods of treatment of injuries, fractures of different locations, such as closed osteosynthesis of pelvic bones, screws, fixation of the blade fractures, closed osteosynthesis blocking extramedullaryplates for fractures of the leg bones, shoulder
Jinimtuiz ЭСа^ЖМЩ QV?3-2018 !
arthroscopy, arthroscopic surgery for pathology of Bancard, osteosynthesis of hip fractures, cannulated screws, without exposure and, under local anesthesia in elderly patients. In 2014 and 2015 injuries in the elderly were treated mainly conservatively 73.3% and 82.1%, respectively, surgical treatment of the traditional methods used in 17.8% and 3.6% in 2014 and 2014 respectively. In 2016, in connection with the introduction of innovative methods significantly increased the
proportion of patients treated by surgical weight innovative methods 42.1% in 2014 compared to 14.3% in 2013 and 8.9% in 2012 (x2 = 18,532, p = 0.001).
Thus, the introduction into practice of traumatology Department of Shymkent city hospital of emergency medical care of modern methods of treatment of injuries in elderly and senile people allowed to improve the results of treatment, to increase the efficiency of trauma - logical care for the elderly and senile age.
REFERENCES
1 Булешова А.М., Булешов М.А., Кудрявцев А.В., Куандыкова А.К., Булешов Д.М., Булешова Р.М., Султанбеков К.А., Ембердиев А.У., Гржибовский Андрей Мечиславович Эпидемиология травматизма в г. Шымкент Южно-Казахстанской области Республики Казахстан: обоснование необходимости создания муниципального регистра травм // Экология человека. - 2016. - №6. - С. 8894.
2 Тлемисов А.С., Булегенов Т.А., Даулетьярова М.А., Тулеуханова А.М., Оразгалиева Ж.Е. Травмы у лиц пожилого возраста // Проблемы социальной гигиены, здравоохранения и истории медицины. - 2015. - №5. - С. 149-157.
3 Е.А. Жармухамбетов Современные технологии в организации травматолого-ортопедической помощи в Казахстане // Вестник КазНМУ. - 2014. - №4. - С. 451-452.
4 А. Т. Махмутов, К. З. Сакиев, Т. С. Сергалиев, К. Т. Абдрахманов, М. М. Сыздыков, Ж. А. Алданова, А. М. Сергалиев, Н. У. Шинтаева Социально-гигиенические проблемы дорожно-транспортного травматизма // Гигиена труда и медицинская экология. - 2016. -№1(50). - С. 269-275.
5 Абдрахманова З.Б., Булешов М.А., Молдалиев И.С., Булешова А.М., Иванов С.В., Гржибовский А.М. Эпидемиология дорожно-транспортного травматизма в Республике Казахстан в 2013-2015 годах // Экология человека. - 2017. - №5. - С. 135-139.
З.Б. Абдрахманова, М.А. Булешов, Е.С. Молдалиев ЦАРТТАР МЕН ЕГДЕ ЖАСТАГЫ НАУЦАСТАР АРАСЫНДАГЫ ЖАРАЦАТТАР
ty^h: Соцгы онжылды;та демографиялык; жагдай барлык; дамыган едерде тургындар арасында егде жэне карт адамдардыц курт
eсуi сипатталады.
Себебi жара;аттану карттар арасында езект мэселелердщ бiрi болып отыр,;арттардыц арасында уйымдастыру алдын алу
шараларын усыну ма;сатында олардыц арасындагы жара;аттыц таралу себептерш талдау езект мэселеш тудырады.
TY^H4i сездер: инновациялы; емдеу эд^терь егде жэне карт жасы, жара;ат, травматологиялы; кемек, емдеу тшмдшп
З.Б. Абдрахманова, М.А. Булешов, Е.С. Молдалиев ТРАВМАТИЗМ СРЕДИ ПАЦИЕНТОВ ПОЖИЛОГО И СТАРЧЕСКОГО ВОЗРАСТА
Резюме: За последние несколько десятилетий демографическая ситуация в мире характеризуется прогрессирующим увеличением численности пожилых и старческих людей в структуре населения практически всех развитых стран.
Поскольку травматизм является актуальной проблемой для пожилых, то возникает актуальная проблема в проведении анализа причин распространённости травматизма среди них с целью своевременного принятия организационных профилактических мероприятий.
Ключевые слова: инновационные методы лечения, пожилой и старческий возраст, травма, травматологическая помощь, эффективность
УДК 612.6
Б.А. Омарова, С.А. Туктибаева
Международный казахско-турецкий университет им. Х. А. Ясави
ОПРЕДЕЛЕНИЕ НИЗКОРОСЛОСЛИ У ПЕРВОКЛАССНИКОВ В ЮЖНО-КАЗАХСТАНСКОЙ ОБЛАСТИ
В данном исследовании впервые оценили распространенность нарушений физического развития детей в Южно-Казахстанской области с использованием международного критерия. В исследование были включены 1498 детей в воз-расте от 6,5 до 7,5 года. Оценка распространенности низкорослости проводилась с помощью стандартного метода WHO-2007. Ключевые слова: физическое развитие детей, низкорослость, WHO-2007
Актуальность темы. Детский период является этапом развития организма, при котором физического развития имеет преимущественно линейный характер, в отличие от подросткового периода, когда показателей развития перестает быть линейным [1]. Ребенок развивается под влиянием целого ряда факторов, из которых следует выделить генетические особенности, детерминирующие его рост во взрослом возрасте, и факторы внешней среды, в которых ключевую роль играет питание. Показатели физического развития детей и подростков широко варьируют в различных странах мира [2]. Так, серьезной проблемой развивающихся стран является
значительная распространенность среди детей и подростков низкорослости как следствие бедности, инфекционных заболеваний и недостаточного питания в раннем детстве, причем в наиболее бедных странах этот показатель достигает 30 % [3]. Тем не менее низкий доход в семьях не единственная причина низкорослости детей, немаловажным фактором являются и нарушения пищевого поведения, крайними проявлениями которых могут служить нервная анорексия и булимия, что в большей степени характерно для стран с высоким уровнем экономического развития [6].
Низкорослости детей и подростков противостоит другой
