Narodna in univerzitetna knjižnica, Ljubljana (NUK)
Naročanje gradiva za izposojo na dom
Naročanje gradiva za izposojo v čitalnice
Naročanje kopij člankov
Urnik dostave gradiva z oznako DS v signaturi
  • Urgentna kraniotomija: ali jo lahko in ali jo moramo izvesti v regionalni bolnišnici? = Emergency craniotomy: should it be or must be performed in a regional hospital?
    Ocepek, Ivan, dr.med.
    Background Most patients with severe head injuries are transported to and operated on in the neurosurgical unit. Some patients are still occasionally operated on in regional hospitals by general ... surgeons to avert progressive neurological injuries and death. The aim of this paper is to analyze this typeof surgical activity in our general hospital. Methods Between 1995 and 2005, 7patients underwent decompressive surgery performed by general surgeons.All were confirmed by the computerized tomography (CT) scan with minimum 5 mm midline shift, severe ventricular compression, or both. We have analyzed the reason why all patients were deemed to be too unstable for transport to the nearest neurosurgical unit which is situated 75 km from our hospital. Results The group of patients consisted of 2 females aged 21-50 years and 5 males aged 32-46 years. All 4 patients with epidural hematoma (EDH) had a good recovering with Glasgow Outcome Scale (GOS) 5 (good recovery with minimal or no disability). With 3 patients with subdural hematoma (SDH), the outcome was not that good and the mean GOS was 2,6, ranging from 4 to 1. The overall mortality was 14.28%. The time from recognition of the nature of the injury by the CT scan to the start of anesthetization ranged from 70 to 20minutes (with the average of 47 minutes). In EDH, the average time was 37 minutes. Conclusions In a modern society with fast communications, there is enough time to transfer patients with EDH or SDH to a neurosurgical unit before the onset of uncal herniation. The aim is to improve the competence andspeed of general hospitals in detection of candidates for surgical decompression, and stress the importance of these patients to be transferred to a neurosurgical unit without any unnecessary delay. The dilemma arises because the condition of patients with expanding mass lesions can deteriorate extremely rapidly, with catastrophic consequences. (Abstract truncated at 2000characters)
    Vir: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 75, št. 12, dec. 2006, str. 805-811)
    Vrsta gradiva - članek, sestavni del
    Leto - 2006
    Jezik - slovenski
    COBISS.SI-ID - 22407641

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