Том 330, № 11 (2009)

The article presents a variant securing of field treatment institutes by mobile command points in combination with creation of automated system of control of a separated medical unit of special purpose and improvement of communications devices, computing and relaying of data. Such improvement of system of control permits to solve governmental tasks and make decision more effective, spending less time.

The work is founded on the results of examination and treatment of 1242 patients with acute pancreatits in 1991-2007. There was compared results of diagnostics and treatment of 520 patients in 1991-1999 (group of comparison) before insertion of protocols of diagnostics and treatment of acute pancreatitis and after their insertion and optimization - 722 patients in 2000-2007 (main group). Compared groups are equitable in all categories. It’s determined that that after insertion of standardized algorithm of diagnostics and treatment of acute pancreatitis in the work of surgical units of the 442nd Regional military clinical hospital of Leningrade military region, it was achieved a decrease of general lethality in conditions of this disease from 8.8% in group of comparison to 3.4% in main group (p<0,05). In conditions of sthenic acute pancreatitis after-operational lethality decreased from 39, 6% to 23,1%, and general lethality - from 33,3% to 15% (p<0,001).

There was effectuated a valuation of effectiveness of using electroneurostimulation in combination with traditional medicinal treatment in psychiatry by 88 patients with different borderline states: asthenoneurotic, asthenodeppessive and vexatiousdepressive syndromes. Control group was formed by 90 patients with similar states, by getting only traditional treatment. Patient’s state was evaluated before treatment, on the 5th and 10th day of treatment by using a scale of general clinical state - severity, a subjective visual-analog scale, a psycho-metric scale of subjective valuation of well-being, activity and mind. On the base of the data there was made a conclusion that DENS-therapy could be used in complex treatment of patients of psychiatric profile with borderline states as well in stationary as in polyclinic conditions.

The article presents in chronological order points of view of national scientists on notion «lightly wounded person» and their contribution in formation and development of system of delivery of health care and treatment of this category of wounded. Organizational processing of system of treatment of lightly wounded persons took place in "December 1941 after publishing of the order of National Defense Commissioner, whereby there was confirmed «Enactment of hospitals for lightly wounded and lightly ill persons». In 1942 there were founded 200 hospitals for lightly wounded persons, to the end of war cot size was 36,5% of general cot size. The article presents data of effectiveness of hospital work during the Great Patriotic War. Also the article presents modern points of view on a question of organization of delivery of medical aid and specialized treatment of lightly wounded and lightly ill persons in brand new organizational-staff structures (medical company of brigade, umeds of operative command, hospitals of lightly wounded of stationary and mobile hospital base, centers of rehabilitation). Were formed main features of modern system of organization of medical aid and surgical treatment of lightly wounded persons.