[Combined trauma of the abdomen and pelvis].
Experience in treatment of 164 patients with combined trauma of abdomen and pelvis is analyzed. Mean age of the patients was 40.1+/-17 years, 94 patients were male, 70 -- female. ISS was 28.6+/-11 points. Lethality was 44.5%, during first day -- 61.6%. High lethality may be associated with mistakes in surgical and traumatological policy. Abdominal surgery was performed in 64 (39%) patients, only in 24 (14.6%) of them laparotomy was curative, the rest 40 (85.4%) patients underwent diagnostic laparotomy. It is demonstrated that diagnostic laparotomy has negative influence on prognosis of combined trauma of the abdomen and pelvis. Adequate traumatological policy has also great influence on lethality, particularly during the first day. Overall lethality of patients with rotary-vertical instability of the pelvis was lower in the group with fixation of the pelvis than in conservatively treated patients (41.7 and 56.6%). Lethality during day 1 in patients with fixed pelvis was 0, without fixation of the pelvis -- 82%. It is concluded that verified indications for laparotomy and active traumatological policy improve treatment results in patients with combined trauma of abdomen and pelvis.
Bokarev
M I
MI
Molitvoslovov
A B
AB
Sergeev
S V
SV
Napit
I
I
Evdokimov
A E
AE
Biriukov
Iu V
IuV
D000007:Abdominal Injuries / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D010388:Pelvis / Q000293:injuries*