ABSTRACT
Objective To evaluate the effects of hypogastric artery ligation to treat massive hemorrhage in pelvic fractures with abdominal organ injuries. Methods The pelvic fractures of 16 patients were classified as Tile B type in 10 cases and C type in 6. Among them there were 6 open fractures and 20 sites of abdominal visceral injuries. The capacity of retroperitoneal hematoma, which was ruptured in 6 cases, ranged from 800 ～2 500ml with 1 400ml on average. The bleeding volume in the survivals was 1 500～5 800ml with 2 600ml on average. Ligation of bilateral hypogastric artery was carried out in all patients with intra abdominal injuries within 6h. Of them, skeletal traction was used in 7 cases while pelvic external fixation in 5 cases. Results One death occured dut to consumptive coagulopathy with hematorrhea. Of the 15 survivals, bleeding was controlled in 8 cases, decreased in 5 and uncontrolled in 2. The effective rate was 81.3%(13/16) and the survival rate 93.8%(15/16). Conclusion When emergency celiotomy is performed for abdominal injuries, a rational application of hypogastric artery ligation can play a positive role in control of pelvic hematorrhea.
ABSTRACT
OBJECTIVE: To elucidate the epidemiological characteristics and to define some preventive strategies for fall injury (FI). METHODS: The medical records of patients admitted following a fall from a certain height between August 1996 and July 1997 were analyzed retrospectively. RESULTS: A total of 138 patients were assessed, with a mortality of 31.2%. The male-to-female ratio was 3.5:1. The persons between 20 and 59 years old were the main victims (81.8%), of which 52.2% were related with their work altitude. The remaining adults fall because of, accidents in daily life, suicide attempts, drug abuse, alcohol, or criminal behavior. There were significant differences between the death group and the survival group in the Revised Trauma Score (RTS) and the Injury Severity Score (ISS) value (P<0.05 and P<0.01, respectively). Six children fall from balconies, open windows or roofs. There were significant differences for the height of fall and RTS value in aged group than those in children, adolescents, and adults (P<0.001, 0.005, 0.05; and P<0.05, 0.01, 0.05, respectively). The mortality of FI was significantly correlated to the height of fall (r=0.897, P<0.005). CONCLUSIONS: Male adults are the main victims, especially the workers at high altitudes. The mortality of FI is significantly correlated to the height of fall. The preventive strategies developed through analyzing the risk factors of fall in different age groups might reduce the injuries and deaths following fall.
ABSTRACT
During the last 4.5 year period, 1, 164 patients with traffic injuries were treated in our hospital. accountingfor 37.5% of the traumatic patients. There were 758 males and 406 females, aged 7 to 89. Of them pedestrians accounted for 70. 4%. There were 389 eases with polytrauma in this series. In the patients with thoracic or abdominal injures, operative rates were 2.5% and 67%, respectively. There were 363 cases whose ISS were over 16. The maximum ISS were 66 in the survivors. Overall mortality was 9.7% with a mean ISS of 35.5. Most deaths occurred in head injuries, The study indicated that the number of pedestrian injury was larger and the injuries were more severe in our conntry than abroad, the pedestrians were often impacted hy buses or trucks and might get injured three times (impact, fall on the ground, crushed by wheels). The authors discussed the clinical features and treatment of injuries of various sites. It is emphasized that traumatology professionalizm is important for saving patients with traffic injuries.