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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ymj</journal-id><journal-title-group><journal-title xml:lang="ru">Якутский медицинский журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Yakut Medical Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1813-1905</issn><issn pub-type="epub">2312-1017</issn><publisher><publisher-name>ЯНЦ КМП</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">ymj-1459</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МАТЕРИАЛЫ ОЧЕРЕДНОГО НОМЕРА «ЯКУТСКОГО МЕДИЦИНСКОГО ЖУРНАЛА»</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>MATERIALS OF THE «YAKUT MEDICAL JOURNAL» NEXT ISSUE</subject></subj-group></article-categories><title-group><article-title>Некоторые вопросы качества оказания специализированной помощи больным с сочетанной черепно-мозговой травмой</article-title><trans-title-group xml:lang="en"><trans-title>Some Aspects of quality of Rendering of Specialized Help to Patients with Combined Craniocerebral Trauma in Multifield Hospital</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лядова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lyadova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лядова Мария Васильевна – к.м.н., врач травматолог ортопед ГКБ №1 им. Н.И. Пирогова, ассистент кафедры РНИМУ им. Н.И. Пирогова</p></bio><bio xml:lang="en"><p>Lyadova Maria Vasilievna, PhD (Candidate of Medical Sciences), doctor traumatologist-orthopedist of the medical ambulance, the state hospital No 1 named by Pirogov N.I., assistant of the  traumatological and orthopedically surgery’s Department of Russian Medical University named by Pirogov N.I </p><p>117 049, Moscow, Leninskiy Prospect, 10  </p></bio><email xlink:type="simple">mariadoc1@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГКБ №1 им. Н.И. Пирогов; ГКб №1 им. Н.И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical University named by Pirogov N.I</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>14</day><month>09</month><year>2025</year></pub-date><volume>0</volume><issue>2</issue><fpage>107</fpage><lpage>110</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лядова М.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Лядова М.В.</copyright-holder><copyright-holder xml:lang="en">Lyadova M.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://ymj.elpub.ru/jour/article/view/1459">https://ymj.elpub.ru/jour/article/view/1459</self-uri><abstract><p>Проведен анализ историй болезни больных с сочетанной черепно-мозговой травмой (СЧМТ), поступивших в ГКБ №1 (г. Москва) за последние 5 лет. Произведена оценка качества догоспитальной и госпитальной помощи, проведен анализ основных ошибок на уровне приемного отделения, в результате которого внедрена система комплексного осмотра пациентов, получивших по механизму высоко энергетическую травму. Тактика лечения переломов длинных костей осуществлялась в зависимости от тяжести ЧМТ. Предварительные результаты проведенных исследований позволяют сделать вывод, что наличие у пострадавшего тяжелой ЧМТ при современном подходе и достаточной технической оснащенности не является противопоказанием к выбору активной тактики лечения переломов длинных трубчатых костей.</p></abstract><trans-abstract xml:lang="en"><p>The treatment of patients with combined craniocerebral trauma (CCT) is associated with clinical difficulties, because its symptoms are very different from other combined trauma. Nowadays the standards in treatment of such patients are not developed fully. Earlier, in 1970-80 years both domestic and foreign researchers have proposed the different scales and schemes for the estimation of such injuries. The State Hospital No 1 named by Pirogov N.I. in Moscow is considered as a multiple trauma centre with powerful diagnostic and clinical base. The article deals with the analysis of disease histories of 400 patients with combined craniocerebral trauma which were treated in this hospital for last five years. The most of the patients was brought to the hospital for the first days after trauma. The quality of pre-hospital and clinical aid was assessed; the mistakes of Reception Department were analyzed. Based on the results of analysis the system of complex inspection of patients with high-energy trauma was embedded in the State Hospital No 1. The tactics of treatment of long bone fractures was performed depending on the severity of head injury. The computer tomography (CT) with the so-called program «combined injury» was embedded. It means the complex approach: patients, who received high-energy and heavy criminal injury, were examined by CT of the brain, chest and pelvis at the same time. It revealed that 13.7% of patients had fractures of the ribs, 8.3% of cases - fractures of the pelvis, 22.8% of cases - signs of brain injury. For the last 10 years the clinic actively applies the principle of one-stage surgical treatment by the participation of multiple surgical teams. Preliminary results of this study let us to conclude that using of this modern approach and sufficient technical equipment allow considering the head injury as not a contraindication to the active choice of tactics of treatment of fractures of long tubular bones.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>экстренная квалифицированная помощь</kwd><kwd>сочетанная черепно-мозговая травма</kwd><kwd>качество медицинской помощи</kwd></kwd-group><kwd-group xml:lang="en"><kwd>emergency medical aid combined craniocerebral trauma</kwd><kwd>quality of medical help</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Вялков А.И. Управление качеством в здравоохранении / А.И. Вялков // Проблемы управления здравоохранением.– 2003.– №1.– С.5-12.</mixed-citation><mixed-citation xml:lang="en">Vyalkov A.I. Quality management in health care / A.I. 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