Hormonal changes in the immediate postoperative period in women with penetrating gunshot wounds of the pelvis
Authors:   Saratov State Medical University named after V.I. Razumovsky, Saratov, Maslyakov V.V. ,   Medical University «Reaviz», Samara, Kapralov S.V. ,   Saratov State Medical University named after V.I. Razumovsky, Saratov, Sidelnikov S.A. ,   Saratov State Medical University named after V.I. Razumovsky, Saratov, Uryadov S.E. ,   Medical University «Reaviz», Samara, Barsukov V.G. ,   Medical University «Reaviz», Samara, Parshin A.V. ,   Saratov State Medical University named after V.I. Razumovsky, Saratov, Polidanov M.A. ,   Saratov State Medical University named after V.I. Razumovsky, Saratov
Published: November 2024

Unfortunately, the problem of traumatic abdominal injuries does not lose its relevance. According to the data presented in the scientific literature, injuries to this anatomical area in the structure of combat wounds occur in 4-7% of observations. At the same time, the most severe injuries occur with wounds in the pelvic region. Goal. To study changes in the hormonal background in dynamics in women with penetrating gunshot wounds of the pelvis in the immediate postoperative period. Materials and methods. 40 patients from among the civilian population who were treated for penetrating gunshot wounds of the pelvis received as a result of local hostilities were selected for scientific work. All patients were female, the average age was 36 ± 4 years (M ± m). It is proved that the immediate postoperative period depends on the time factor that occupies the interval from the moment of injury to the surgical intervention. Based on this, we have formed two clinical groups. In the first (A), the wounded were selected in the number of 20 (50%) people, whose time interval did not exceed 60 minutes, in the second (B) – 20 (50%) wounded, whose time interval exceeded 60 minutes. In the course of the study, hormones related to stress were studied: thyroid-stimulating hormone, cortisol, insulin-like growth factor, leptin, adrenaline, serotonin, histamine. Results. The study shows that gunshot wounds of the pelvis in women lead to changes in the hormonal background, which depend on the time elapsed from the moment of injury to the start of surgical treatment and vary depending on the day that has passed since the surgical intervention. Starting from the first day after surgery, an increase in hormones was registered, the regulation of which is by the hypothalamic-pituitary system, as well as hormones produced by the adrenal cortex. First of all, it is an insulin-like growth factor and adrenaline. At the same time, the increase in hormones in the two groups was different, in group A, where help was provided faster, respectively, the traumatic factor was less, the amount of hormones increased compared to normal indicators, however, it was less compared to group B, where the traumatic factor was significantly longer. At the same time, hormonal recovery in group A was also faster compared to group B. During the study, it was found that in group B, starting from 5-7 days after the surgical intervention, there was an increase in the amount of glucose in the blood serum, and this was noted against the background of an increased content of hormones involved in metabolic processes. The restoration of the serum glucose index occurred on the 17th-19th day after the surgical treatment, when there was a complete restoration of the hormonal background in the operated patients. Conclusion. Based on the conducted research, it can be concluded that gunshot wounds of the pelvis in women lead to changes in the hormonal background, which depend on the time elapsed from the moment of injury to the start of surgical treatment and vary depending on the day that has passed since the surgical intervention.