Анализ результатов лечения ранений малого таза с повреждением органов репродуктивной системы у женщин в условиях локального вооруженного конфликта

Abstract

Summary. The aim of the study was to analyze the results of treatment of pelvic gunshot wounds with damage to the reproductive system organs in women in a local armed conflict. Materials and research methods. A retrospective analysis of the results of treatment of 86 patients with pelvic gunshot wounds with genital damages was performed. All the patients were members of the general population. Treatment was carried out at Grozny City Clinical Hospital in 1997-2005. The mean age of patients was (25±7) years. Female patients of fertile age with gunshot wounds in the pelvic area with damages of reproductive organs were included in the study. The following patients were excluded: patients younger than 18 and older than 45 years; patients with concomitant injuries of the chest, head, limbs, and patients in agonal state. Study results and their analysis. The results of the study showed that most of the women had severe injuries, which resulted in bleeding, pain syndrome and shock as a consequence. Severe injuries were often combined with pelvic injuries and required wide laparotomy and revision of the abdominal cavity organs. The signs of peritonitis due to concomitant injuries at the moment of admission limited the choice of tactics. In the nearest postoperative period the complications were related mainly to the purulent-inflammatory processes in 24.4% of cases. Nineteen patients died (22.1%). The main causes of lethal outcome were: shock in 15.1% of cases; purulent-septic complications in 6.9% of cases. It has been concluded that severe gunshot wounds of the pelvic organs in women, accompanied by the reproductive system injuries, are characterized by a severe postoperative course, a great number of lethal outcomes and require urgent hospitalization in a multidisciplinary hospital.