血管造影栓塞明胶海绵栓塞剂在骨盆骨折大出血中应用20例

Application of angiographic gelfoam sponge embolization agents in 20 patients with massive hemorrhage following pelvic fracture

解放军第二军医大学长海医院骨科2001-01/2003-08在入院3～8h内急诊行明胶海绵栓塞剂材料血管造影栓塞治疗骨盆骨折大出血患者20例,男12例,女8例;年龄18～70岁,平均43.4岁。8例将导管超选择性插入病变髂内动脉分支内,用明胶海绵颗粒与对比剂一起注入。12例将导管置于髂内动脉主干用明胶海绵颗粒与对比剂一起注入。全部患者均顺利完成栓塞治疗,栓塞后患者血压逐步回升至正常水平,未出现严重的栓塞并发症。1例于血压稳定后病情恶化死亡。结果提示使用明胶海绵栓塞剂材料血管造影栓塞是骨盆骨折大出血的一种安全、迅速、有效的止血措施。

A total of 20 patients with massive hemorrhage for pelvic fracture, underwent angiographic embolization with gelfoam sponge embolization agents in 3-8 hours after admitted at the Department of Orthopedics, Changhai Affiliated Hospital of Second Military Medical University of Chinese PLA between January 2001 and August 2003 were selected. The patients aged ranged from 18-70 years （mean 43.4-year-old）, including 12 male and 8 female. Conduits were inserted into the internal iliac artery embranchment of 8 cases with method of ultraselection, and gelfoam sponge grain and contrast medium were injected together. Conduits combined with gelfoam sponge grain and contrast medium were inserted into 12 cases＇ pathic internal iliac artery bole. The whole 20 cases were performed endovascular embolization, and blood pressures turned to normal level after operation gradually without serious complications of embolization. One case died of deterioration after blood pressure stabilization. The result reveals that anglo-graphic embolization with gelfoam sponge embolization agents is a safe, quick and effective method of controlling the severe hemorrhage caused by pelvic fracture.