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Retroperitoneal hemorrhages in pelvio-abdominal traumas: diagnosis, treatment and prophylaxis of complications


Author: Paladii Irina
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2016
Scientific adviser: Gheorghe Ghidirim
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Vladimir Kusturov
doctor habilitat, associate professor (docent)
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 20 April, 2016
Approved by NCAA on the 3 June, 2016

Abstract

Adobe PDF document – 2.90 Mb / in romanian

Thesis

CZU 616.718.19-001-005.1-089

Adobe PDF document 14.49 Mb / in romanian
159 pages

Keywords

retroperitoneal hemorrhage/hematoma, pelvio-abdominal trauma, prophylaxis

Summary

The thesis includes an introduction, 5 chapters, conclusions, recommendations, 41 tables, 78 figures, 224 bibliographic references, 121 pages of main text. The obtained results were published in 37 publications.

Research domain: 321.13 – surgery.

Purpose: To improve the results of retroperitoneal hemorrhage diagnosis, to increase the efficiency of prophylaxis and treatment of retroperitoneal hematoma complications in pelvioabdominal traumas by diagnostic and treatment tactics optimization.

Objectives. To define the informative value of diagnostic methods; to study sources, zones and spread of post-traumatic retroperitoneal haemorrhages; to develop diagnostic and treatment algorithm for patients with retroperitoneal hemorrhage in trauma; to determine the prognostic factors of retroperitoneal hematoma complications and mortality in pelvio-abdominal trauma; to analyze the treatment results of retroperitoneal hematoma complications.

Novelty and scientific originality. The topographic, anatomical and morphological data; diagnostic features, evolution and treatment of retroperitoneal hematoma complications were studied. It was created and applied the lumbar device. It was developed the diagnostic and treatment algorithm for patients with retroperitoneal hemorrhage.

Scientific problem solved. It is proved that in pelvio-abdominal trauma, there is a risk of developing RP hemorrhages and its complications, prevention of which, needs an early immobilization with lumbar device followed by osteosynthesis of the pelvis with external fixation device.

Theoretical significance. It was confirmed the theory of the distribution patterns of retroperitoneal hemorrhage. In theory, the importance of the scale of damage was confirmed by establishing the interconnection between the type of pelvic fractures, severity of injury, complications, morbidity and mortality. There were established the factors of complications and unfavorable outcomes.

Applicative value. There were established the criteria of non/surgical treatment of retroperitoneal hematoma; the diagnostic and treatment recommendations were elaborated depending on patients` hemostability, localization and volume of retroperitoneal hematoma. There have been defined the typical complications and preventive measures.

Implementation of the scientific results. The results of the present study were implemented in the Institute of Emergency Medicine, as well as in the training curricula at the Department of Surgery nr.1 “Nicolae Anestiadi”, PI SUMPh „Nicolae Testemitanu”.