Автореферат (1154902), страница 6
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Воснову определения тактики неотложного диагностического поиска и оказаниянеотложной специализированной медицинской помощи следует полагатьсиндромальный подход, который должен иметь многоуровневый характер.Комбинация и характер патологических синдромов первого и второго порядковопределяют конкретное содержание комплекса диагностических и лечебныхмероприятий.Sergei L. Brizhan’ (Russia)Improving emergency tertiary care for metropolitan patients with acutenontraumatic spinal conditions: an organizational and clinical studyObjective. To improve metropolitanwide delivery of emergency tertiary care topatients with nontraumatic spinal conditions.Materials and methods. One thousand three hundred thirty six patients withacute degenerative, metastatic and infectious conditions of the spine wereretrospectively included, of which 865 patients were managed in the St.
Petersburgmetropolitan spine center (cohort) and 471 patient were managed in a few city districthospitals (controls) (р > 0,05). From these data, a number of clinical and surgicalvariables were sought and the nonparametric statistics were calculated.Results. Metropolitan nontraumatic spinal care benefited from the institutionof an acute-care-hospital-based spine surgery service, adequate equipment andsupplies, focused training for physicians and nursing staff, stable financing, andeffective triage pathways. Diagnosis and treatment pathways of acute specialized carefor spinal disorders should implement a two-tier syndrome-based system.
Under thissystem, the combination and the patterns of the first- and second-tier syndromes definethe interventions necessary along the pathway..
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