RESUMO
The results of the treatment of 316 patients with various injuries of abdomen are summarized. 144 (45.6%) of the patients were operated on vital indications (internal bleeding, peritonitis). Additional instrumental examination was necessary in 172 (54.4%) of the patients. Urgent diagnostic laparoscopy was performed in 118 of them. This procedure is indicated in patients with the absence of the symptoms of "acute abdomen" hospitalised in less than 2 hours from the moment of penetrating injury. It is also indicated in case of a doubtful diagnosis in a blunt injury of abdomen, and in alcoholic intoxication. Three groups of the patients were distinguished: 1) patients with indications for urgent surgery (38.1%); 2) patients with indications for conservative treatment (17.8%); 3) patients with indications for out-patient follow-up (44.1%). This policy made it possible to decrease the number of diagnostic laparotomies to 11%, the period of limited disability by 5.8 + 0.3 days, decrease lethality to 6%.
Assuntos
Traumatismos Abdominais/diagnóstico , Laparoscopia/métodos , Traumatismos Abdominais/classificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
A clinical case of using an original staple with the "shape memory" for hemostasis of a hepatic gunshot injury is described. This method gives possibility to remove the syaple out in the postoperative period.
Assuntos
Fígado/lesões , Técnicas de Sutura , Ferimentos por Arma de Fogo/cirurgia , Seguimentos , Hemorragia/etiologia , Hemorragia/cirurgia , Humanos , Fígado/cirurgia , Masculino , Ferimentos por Arma de Fogo/complicaçõesRESUMO
Experimental and clinical substantiation of the use of an original alloyed staple with shape memory allowed it to be recommended for closure of deep wounds of the liver when all other known methods and constructions are ineffective. The staple causes a lesser zone of necrosis than that produced by catgut in closure of a similar wound, and it can be removed with no loss of blood. Consequently, its application is a method of today, causes little injury, and is promising.
Assuntos
Hemostasia Cirúrgica/instrumentação , Fígado/lesões , Fígado/cirurgia , Grampeadores Cirúrgicos , Grampeamento Cirúrgico/instrumentação , Ligas , Animais , Desenho de Equipamento , Hemostasia Cirúrgica/métodos , Humanos , Masculino , RatosRESUMO
The paper summaries authors' experience with lifetime and postmortem pulmonary changes in 223 victims with severe craniocerebral injury, as well as the data available in literature on this point. The investigations have shown that microcirculatory disorders make a great contribution to the development of pulmonary complications and revealed specific feature of the natural history of the shock lung in patients with severe craniocerebral injury. The paper provides strong evidence for the neurotrophic pattern of pulmonary complications and proposes a scheme of their development in this injury.
