骨科英文书籍精读（184）｜骨盆损伤（4）
Clinical assessment
Fracture of the pelvis should be suspected in every patient with serious abdominal or lower limb injuries. There may be a history of a road accident or a fall from a height or crush injury. Often the patient complains of severe pain and feels as if he has fallen apart, and there may be swelling or bruising of the lower abdomen, the thighs, the perineum, the scrotum or the vulva. All these areas should be rapidly inspected, looking for evidence ofextravasation of urine. However, the first priority, always, is to assess the patient’s general condition and look for signs of blood loss. It may be necessary to start resuscitation before the examination is completed.
The abdomen should be carefully palpated. Signs of irritation suggest the possibility of intraperitoneal bleeding. The pelvic ring can be gently compressed from side to side and back to front. Tenderness over the sacroiliac region is particularly important and may signify disruption of the posterior bridge.
A rectal examination is then carried out in every case. The coccyx and sacrum can be felt and tested for tenderness. If the prostate can be felt, which is often difficult due to pain and swelling, its position should be gauged; an abnormally high prostate suggests a urethral injury.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
suspect /səˈspekt/v. 怀疑；猜想n. 嫌疑犯adj. 靠不住的；可疑的
bruising /ˈbruːzɪŋ/n. 挫伤adj. 殊死的；十分激烈的v. 擦伤（bruise的ing形式）
perineum /ˌperɪˈniːəm/n. [解剖] 会阴
scrotum /ˈskroʊtəm/n. [解剖] 阴囊
extravasation /ik,strævə'seiʃən/n. 溢出；溢出物；[地质] 熔岩外喷
extravasation of urine. 尿外渗。
resuscitation /rɪˌsʌsɪˈteɪʃn/n. 复苏；复兴；复活
palpate /pælˈpeɪt/adj. （有）触须的v. 触诊
irritation/ˌɪrɪˈteɪʃn/n. 刺激；激怒，恼怒，生气；兴奋；令人恼火的事
Signs of irritation suggest the possibility of intraperitoneal bleeding. 刺激迹象提示腹腔出血的可能性。
rectal /ˈrektəl/adj. 直肠的
coccyx /ˈkɑːksɪks/n. 尾骨；尾椎
百度翻译：
临床评估
对于腹部或下肢严重损伤的患者，应怀疑骨盆骨折。可能有交通事故或从高处坠落或挤压伤的病史。病人经常抱怨剧痛，感觉像是摔了一跤，下腹、大腿、会阴、阴囊或外阴有肿胀或瘀伤。所有这些区域都应迅速检查，寻找尿液外渗的证据。然而，第一要务，总是，评估病人的一般情况和寻找失血的迹象。可能有必要在检查完成前开始复苏。
腹部应仔细触诊。刺激迹象表明可能有腹腔内出血。骨盆环可以从一侧到另一侧和从后到前轻轻压缩。骶髂区的压痛尤其重要，可能意味着后桥的破坏。
然后对所有病例进行直肠检查。可以摸到尾骨和骶骨，并测试是否有压痛。如果可以感觉到前列腺，由于疼痛和肿胀而很难感觉到，就应该测量它的位置；前列腺异常高表明尿道受伤。