动脉栓塞术治疗骨盆骨折大出血的临床观察

Clinical therapeutic effect of transcatheter arterial embolization for treating massive hemorrhage in pelvic, fracture

目的评价经导管髂动脉栓塞术（TAE）治疗骨盆骨折大出血的疗效。方法收集我院自2006—01—2009—09骨盆骨折大出血患者37例，根据治疗情况分为动脉栓塞术组（14例）和非动脉栓塞术组（23例）。动脉栓塞术组将导管插入髂内动脉造影，超选出出血动脉后栓塞；不能超选者，以直径5～8mm弹簧圈栓塞髂内动脉主干。非动脉栓塞术组采用常规治疗。结果两组输血量比较差异有统计学意义（P〈0．05）；非动脉栓塞术组患者造影后均见对比剂外溢，呈斑片状或条状染色。动脉栓塞术治疗后于患侧髂总或髂内动脉造影复查，对比剂外溢现象消失，动脉栓塞术治疗后14例患者血压均于术后2h内逐步平稳回升，24h内恢复至正常水平。结论经导管动脉栓塞术治疗骨盆骨折大出血是一种简捷、微创、有效的急救止血措施。

Objective To evaluate the clinical therapeutic effect of transcatheter arterial embolizatiou （TAE） for treating massive hemorrhage in pelvic fracture. Methods To collect 37 cases of pelvic fractures with bleeding in our hospital from January 2006 to September 2009. The patients were divided into two groups： arterial embolization treatment group （14 cases） and non- arterial embolization treatment group （23 cases ）. The arterial embolization group was treated by super- selective catheterization, otherwise the trunk of iliac artery would be coiled with a spring ring of a diameter from 5 to 8 mm. Non - arterial embolization group were treated with conventional therapy. Results The two groups had significant differences in blood transfusion （ P 〈 O. 05 ）. The contrast agent was seen to leak out and spot - chip or strip - like stains appeared in vascular embolization treatment group. After arterial embolization treatment, contrast extravasation phenomenon disappeared by re- examination of the ipsilateral iliac or internal iliac arterial angiography. Blood pressure of 14 patients had risen gradually within 2 hours after the operation and returned to normal levels within 24 hours. Conclusion The measures of treating pelvic fracture bleeding by transcatheter arterial embolization are simple, minimally invasive and effective.