骨盆骨折出血超选择动脉栓塞的影像学基础

Imageologic foundation of ultraselection arterial embolism for pelvic fracture with hemorrhage

[目的]探讨骨盆动脉吻合的影像学特点及骨盆骨折出血超选择动脉栓塞的方法。[方法]自1999年1月-2005年6月，60例患者因血流动力学不稳而行骨盆动脉造影。男42例，女18例；年龄21—52岁，平均34．5岁。对造影片上骨盆动脉吻合出现的类型及数量进行观测。[结果]从骨盆的动脉造影上观测到的动脉吻合支为：腰动脉与髂腰动脉100％；髂腰动脉与旋髂深动脉88．33％：闭孔动脉与腹壁下动脉吻合（或髂外动脉）36．67％；臀下动脉与阴部内动脉吻合26．67％；骶外侧动脉与骶中动脉及对侧骶外侧动脉吻合100％；臀下动脉与旋股内外动脉及股深动脉升支吻合56．67％；臀上动脉与臀下动脉吻合61．67％。[结论]骨盆骨折出血时，应实施超选择栓塞即栓塞出血动脉的断端及其吻合支，从而减少动脉栓塞引起的并发症。

[ Objective ] To study the imageologic characteristic of pelvic arterial anastomosis and the method of uhraselection arterial embolism for pelvic fracture with hemorrhage. [ Method ] From 1999. 1 -2005.6,60 patients were undergone pelvic arteriography. The patient ages ranged from 21 to 52 years of age （ mean ,34.5 ） ,and 42 were male, 18 were female. Measure the types and number of pelvic arterial anastomosis. [ Result] The types and number of pelvic arterial anastomosis were observed by pelvic arteriography as follows： the lumbar artery with iliolumbal artery 100% ; the iliolumbal artery with deep iliac circumflex artery 83.33% ; the obturator artery with inferior epigastric artery （ or external iliac artery） 36. 67% ; the lateral sacral artery with coccygeal artery 100% ; the inferior gluteal artery with internal pudendal artery 26. 67% ; the inferior gluteal artery with deep femoral artery 56. 67% ; the superior gluteal artery with inferior gluteal artery 61.67%. [ Conclusion] For pelvic fracture whith hemorrahge,the best treatment of the pelvic arterial disruption is embolization of injured arteries and their anastomosis.