摘要
目的评价急诊介入手术治疗骨盆骨折合并大出血的临床疗效。方法回顾性分析我院2006年1月至2013年1月收治的骨盆骨折大出血患者96例,其中采用动脉栓塞方法治疗40例,非动脉栓塞治疗56例。非动脉栓塞组患者采用外科常规治疗;动脉栓塞组患者行双侧髂内动脉造影,超选择至出血动脉进行栓塞治疗,必要时以弹簧圈栓塞髂内动脉主干。分析比较两组患者治疗效果的差异。结果非动脉栓塞组患者,死亡率为19.6%(11/56),输血量为(2 200.3+50.9)mL,住院天数为(40.8+6.5)d;动脉栓塞组死亡率为5%(2/40),输血量为(1 200.1+65.3)mL,住院天数为(36.3+8.4)d。两组患者的死亡率及输血量差异均有统计学意义(P<0.05),而住院天数无明显统计学差异(P>0.05)。结论经导管动脉栓塞术治疗骨盆骨折大出血是一种快速、高效的急救止血措施,能有效地降低患者的死亡率。
Objective To evaluate the clinical effect of emergency interventional treatment for pelvic fractures with mas-sive hemorrhage. Methods A retrospective analysis was performed in 96 cases of pelvic fractures with massive hemorrhage in our hospital from Jan. 2006 to Jan. 2013. Fifty-six cases underwent non-arterial embolization treatment,whereas 40 cases recie-ved arterial embolization treatment. All patients in non-arterial embolization group were treated with conventional surgical oper-ation. Patients in the arterial embolization group were treated by bilateral internal iliac artery angiography and transcatheter ar-terial embolization. The trunk of internal iliac artery would be coiled with a spring ring while do not super-selective catheteriza-tion. The clinical therapeutic effect in two groups was observed. Results Mortality,volume of blood transfusion and the dura-tion of hospitalization in non-arterial embolization treatment group was 19. 6%（11 / 56）,（2 200. 3 ＋ 50. 9）mL and（40. 8 ＋6. 5）days,respectively. Mortality,volume of blood transfusion and the duration of hospitalization in arterial embolization treat-ment group was 5%（2 / 40）,（1 200. 1 ＋ 65. 3）mL and（36. 3 ＋ 8. 4）days,respectively. Significant difference in mortality and blood transfusion volume between the two groups was observed（P ﹤ 0. 05）. Conclusion As compared with non-arterial embolization treatment,the advantages of transcatheter arterial embolization in treatment of pelvic fractures with massive hemor-rhage are more simple and effective,especially the mortality of patients was obviously decreased.
出处
《实用骨科杂志》
2014年第8期704-707,共4页
Journal of Practical Orthopaedics
关键词
骨盆骨折
大出血
介入治疗
pelvic fracture
massive hemorrhage
interventional treatment
