急诊应用动脉栓塞术治疗骨盆骨折大出血

Emergency arterial embolization therapy of massive hemorrhage for pelvic fracture

目的 探讨急诊应用动脉栓塞术治疗骨盆骨折大出血的临床疗效及方法。方法 59例骨盆骨折大出血，接诊时均处于失血性休克状态，23例由急诊科直接送导管室、14例外科手术后血压未上升或不稳定、22例保守治疗2．0～16小时血压不稳定或持续下降而行急诊动脉栓塞术，选择性或超选择性髂内动脉或分支栓塞。栓塞剂取明胶海绵。结果 59例栓塞全部成功，立刻止血，血压上升或稳定。结论 急诊应用髂内动脉栓塞术治疗骨盆骨折大出血，是一种行之有效、立竿见影的急救止血手段。

Objective To evaluate therapic effect of emergency arterial embolic treatment for massive hemorrhage for pelvic fracture. Methods 59 cases with massive hemorrhage for pelvic fracture were all in hemorrhagic shock. Selective or superselective emergency internal iliac arterial or its braches＇ embolization therapy were used. In 59 cases, 23 cases were directly sent to ductroom from the department of emergency,14 cases whose blood pressures couldn＇t recover or were instability after surgery and 22 cases whose blood pressures were instability or continual desending after 2.0-16 hours of conservative therapy were sent to ductroom. Embolization material was gelfoam. Results All 59 cases embolized successfully. Bleeding quickly stopped and blood pres- sures recovered or steadied after embolization. Conclusion Emergency internal iliac arterial embolization is a quick, effective hemostasis measure for treating massive hemorrhage for pelvic fracture.