| Abstract | Traumatska intrakranijalna krvarenja (TIK). Jedna su od najčešćih
kraniocerebralnih ozljeda koje u većini slučajeva zahtijevaju kirurško liječenje.
Razlikujemo četiri vrste intrakranijalnih krvarenja: epiduralno krvarenje ili
epiduralni hematom, subduralno krvarenje koje može biti akutno ili kronično, te
subarahnoidalno, četvrta vrsta TIK su intracerebralna krvarenja koja predstavljaju
krvarenja u sam parenhim mozga. Navedeni hematomi su udruženi s traumatskim
nagnječenjima mozga. Razlikujemo krvarenja koji su posljedica traume i one koji
nastaju spontano. Prijem takvih bolesnika najčešće je hitni te se bolesnik smješta u
jedinicu intenzivnog liječenja ili priprema za operacijski zahvat.
Cilj ovog diplomskog rada je ustanoviti incidenciju hitnih operacija
bolesnika s TIK s obzirom na dobnu skupinu, spol i mjesto nastanka krvarenja u
vremenskom periodu od 01.01.2017. do 31.12.2021. Prilikom postavljanja hipoteze
pretpostavlja se da će biti uočena statistički značajna razlika s obzirom na
promatrane dijagnoze, spol, životnu dob te godinu kad se desilo traumatsko
intrakranijalno krvarenje. Podaci od 587 pacijenata koji su obuhvaćeni ovim
istraživanjem prikupljeni su iz protokola izvršenih operacija u neurokirurškom
operacijskom bloku za svakog pojedinog bolesnika., a obrađeni su u Microsoft
Excelu 2019.
Na prikupljenim podatcima učinjena je statistička analiza i obrada podataka
te su prikazane povezanosti i razlike kod analiziranih pitanja na analizirane
pokazatelje. Kategorijski podatci su predstavljeni apsolutnim i relativnim
frekvencijama, a prikazani su tablično i grafički putem dijagrama. Razlike
kategorijskih varijabli su testirane hi kvadrat testom, a po potrebi Fisherovim
egzaktnim testom. Razina značajnosti bit će postavljena na 0,05.
Pregledom podataka u vezanih za spol ispitanika može se uočiti kako je
64,7% ispitanika muškog spola, dok je 35,3% ispitanika ženskog spola, a kod dobnih
kategorija 3,2% ima 16 – 29, 8,2% ima 30 – 50, 29,7% ima 51 – 70, dok 58,9% ima
71 i više godina. Kod dijagnoze 39,8% imalo je akutni subduralni, 37,9% kronični
subduralni, a 7,7% epiduralni hematom, dok je 14,6% bio intracerebralni hematom. U zaključku ovog diplomskog rada osvrnula sam se na mogućnost
poboljšanja kvalitete života bolesnika nakon kirurškog liječenja intrakranijalnih
krvarenja a sve u svrhu postizanja njihovog osobnog zadovoljstva jer
kraniocerebralne ozljede usprkos kontinuiranom liječenju mogu rezultirati velikim
invaliditetom. Potpora obitelji oboljelog značajna je za oporavak bolesnika za
vrijeme boravka u zdravstvenoj ustanovi ali i kod kuće. Važno je dakle obaviti
edukaciju oboljelog i članova obitelji o specifičnostima bolesti, primjeni terapije i
zdravstvene njege. |
| Abstract (english) | Traumatic intracranial hemorrhage (TIH). They are one of the most common
craniocerebral injuries that in most cases require surgical treatment. We distinguish
four types of intracranial hemorrhages: epidural hemorrhage or epidural hematoma,
subdural hemorrhage, which can be acute or chronic, and subarachnoid hemorrhage.
The mentioned hematomas are associated with traumatic contusions of the brain. We
distinguish between bleedings that are the result of trauma and those that occur
spontaneously. Admission of such patients is usually urgent, and the patient is placed
in the intensive care unit or prepared for surgery.
The aim of this diploma thesis is to determine the incidence of emergency
operations for patients with TIK with regard to age group, gender and place of
bleeding in the period from 01.01.2017. until 31.12.2021. When setting up the
hypothesis, it is assumed that a statistically significant difference will be observed
with regard to the observed diagnoses, gender, age and the year when the traumatic
intracranial hemorrhage occurred. Data from 587 patients included in this research
were collected from the protocol of operations performed in the neurosurgical
operating room for each individual patient, and were processed in Microsoft Excel
2019.
A statistical analysis and data processing was performed on the collected data, and
connections and differences between the analyzed questions and the analyzed
indicators were presented. Categorical data are represented by absolute and relative
frequencies, and are presented tabularly and graphically through diagrams.
Differences in categorical variables were tested with the chi-square test and, if
necessary, with Fisher's exact test. The significance level will be set at 0.05.
By reviewing the data related to the gender of the respondents, it can be seen that
64.7% of the respondents are male, while 35.3% of the respondents are female, and
in the age categories 3.2% are 16-29, 8.2% are 30- 50, 29.7% are 51-70, while 58.9%
are 71 and older. At diagnosis, 39.8% had acute subdural, 37.9% chronic subdural,
and 7.7% epidural hematoma, while 14.6% had intracerebral hematoma.
In the conclusion of this thesis, I referred to the possibility of improving the quality
of life of patients after surgical treatment of intracranial hemorrhages, all for the
purpose of achieving their personal satisfaction, because craniocerebral injuries,
despite continuous treatment, can result in severe disability. The support of the
patient's family is important for the recovery of the patient during his stay in the
health facility and at home. It is therefore important to educate the patient and family
members about the specifics of the disease, the application of therapy and health
care. |
