ПРОГНОЗУВАННЯ РЕЗУЛЬТАТІВ ЛІКУВАННЯ ПОСТРАЖДАЛИХ З ЧЕРЕПНО-МОЗКОВОЮ ТРАВМОЮ ЗАЛЕЖНО ВІД ЇЇ ТЯЖКОСТІ ТА НАЯВНОСТІ АЛКОГОЛЮ В КРОВІ

The course and prognosis of traumatic brain injury (TBI) are influenced by primary and secondary factors, which is important in the prevention and treatment of repeated ischemic attacks. The aim of the study was to evaluate the results of treatment of victims with traumatic brain injury depending on its severity and alcohol intoxication. Material and methods. During the period from 2014 to 2024, 546 patients with isolated traumatic brain injury were treated in the neurosurgical department of the Chernivtsi Emergency Hospital. Depending on the severity and alcohol consumption, the patients were  divided into two study groups: the main group of 246 people (alcohol was detected in the blood) and the comparison group - 300 patients with traumatic brain injury of various etiologies, in whom no signs of alcohol intoxication were detected. Treatment of these patients depending on the severity of traumatic brain injury and the presence of alcohol intoxication was carried out according to certain algorithms. Results of the study and their discussion. The effectiveness of treatment of patients with TBI without and with alcohol intoxication in the acute period depends on the provision of specialized medical care at the prehospital stage, timely control and correction of ICP and CPP, which affects the results of treatment of patients. In patients who underwent dynamic monitoring of ICP and CPP and its constant correction, compared with those who did not undergo such monitoring, it was possible to significantly improve the results of treatment. The following criteria are significant for the prognosis of the postoperative course in patients with TBI: preoperative - impaired consciousness, alcohol intoxication during the injury, displacement of median structures, large volume of hematomas, hemorrhage into the ventricles of the brain; intraoperative – arterial hypotension; postoperative - increase and maintenance of ICP against the background of its correction, decrease in CPP, nosocomial pneumonia. Conclusions. 1. During hospitalization, the greatest attention is paid to victims with impaired consciousness of 8 points on the Glasgow coma scale (GCS) and patients with alcohol intoxication during the injury, who need to undergo CT, determine the type and volume of hematoma, and the degree of displacement of median structures. 2. In the case of detection of hemorrhage in the ventricles of the brain, the prognosis for treatment is considered unfavorable, when  detecting displacement of median structures - relatively unfavorable, and in the event of nosocomial pneumonia, intraoperative arterial hypotension, ICP above 15 mm Hg against the background of its constant correction - unfavorable.