OUR EXPERIENCE IN CONSERVATIVE TREATMENT OF SPLEEN INJURY IN CLOSED ABDOMINAL TRAUMA

The spleen has a number of important functions, the main of which are participation in hematopoiesis, the body's immune status, and an important role in the hemostasis system [2, 5]. In particular, after splenectomy, there is a change in the main indicators of the vascular-platelet hemostasis link: an increase in the number of platelets and their functional activity, including adhesive ability, the reaction of the release of platelet factors is disturbed, and the retraction index decreases [7]. Changes can also be traced in the coagulation link of the hemostasis system: there is a shortening of the activated partial thromboplastin time, an increase in the concentration of fibrinogen, and inhibition of fibrinolysis. All this leads to the development of thrombotic complications. Under our supervision there were 25 victims with damage to the spleen with a combined injury of the abdomen, who underwent conservative hemostatic therapy. They were combined with skull trauma in 8 (32.0%) cases, chest - in 10 (40.0%) cases, pelvis and limbs - in 7 (28.0%) cases. Of these, there were 19 men (76.0%), women - 6 (24.0%), the average age was 29.5±1.5 years. The causes of the combined injury of the spleen were: a fall from a height - in 13 (52.0%) patients, a car injury - in 12 (48.0%) patients. Terms of hospitalization of patients with spleen injury from the moment of injury: up to 1 hour - 18 (72.0%), from 1 to 3 hours - 7 (28%) victims. car injury - in 12 (48.0%) patients. Terms of hospitalization of patients with spleen injury from the moment of injury: up to 1 hour - 18 (72.0%), from 1 to 3 hours - 7 (28%) victims. car injury - in 12 (48.0%) patients. Terms of hospitalization of patients with spleen injury from the moment of injury: up to 1 hour - 18 (72.0%), from 1 to 3 hours - 7 (28%) victims. The main criterion for choosing conservative treatment of patients was the presence of stable hemodynamics. All patients at admission, in addition to the clinical examination, underwent ultrasound every 6-8 hours in dynamics, multislice computed tomography (MSCT) of the abdominal cavity, a plain radiograph of the abdominal cavity and other anatomical regions by localization, a general blood and urine test, and a coagulogram.