骨盆骨折大出血的急诊介入治疗

Acute Interventional Therapy in Massive Hemorrbage of Pelvic Fracture

目的探讨介入栓塞髂内动脉治疗骨盆骨折所致大出血的临床价值。方法对20例骨盆骨折合并失血性休克的患者行紧急髂内动脉造影,发现16例髂内动脉或其分支出血,3例出血部位不明,19例患者均用明胶海绵栓塞两侧髂内动脉。结果 20例失血性休克患者19例成功栓塞,栓塞均在2 h 内完成,其中18例患者栓塞后活动性出血停止,血压迅速回升,休克得到纠正;1例在造影过程中死亡而未行栓塞;1例栓塞成功后血压回升后又下降,终因失血性休克而死亡。结论急诊介入栓塞髂内动脉是治疗骨盆骨折大出血的首选方法,具有安全、迅速、准确、疗效高的优点。

Objective To discuss the clinical value of interventional embolism of internal iliac artery in treatment of the massive hemorrhage of polvic bone freature disease. Methods The urgent interual iliac artery radiography for 20 cases of pelvic bone facture and merge losing blood shock patients, 16 cases of discovered internal iliac arteries or its branch bled ,3 cases hemorrhagic point was not clear, 19 cases used the gelatin sponge to embolize two sides of internal iliac arteries. Results 20 cases of blood shock patients reccvered after successful embolism, all the embolism processes completed in two hours, the actine hemorrhage stopped after 18 cases with embolism, the blood pressure rapidly rose, 1 case olied before embolism, 1 case succeed embolism, the blood pressure rose and dropped soon again, and eventually died of hemorrhagic shock. Conclusion The emergent interventional embolism of internal iliac artery is the first chaice method to treat the massive hemorrhage of pelvic bone fractrue diseases, with the merit of safe, rapid, accurate, and effective.