骨盆外固定架早期治疗不稳定性骨盆骨折临床应用研究

Clinical application research of unstable pelvic fracrures treated by external fixator in early period

目的探讨在损伤控制理论指导下，应用外固定架在不稳定性骨盆骨折早期治疗的意义。方法对37例血流动力学不稳定的不稳定性骨盆骨折急诊采用外固定架固定患者的临床资料进行回顾性分析，观察植入外固定架前后的平均动脉压、心率及休克指数等量化指标的变化情况。结果37例合并血流动力学不稳定的不稳定性骨盆骨折患者，急诊行外固定架固定，积极抗体克治疗，成功抢救32例（86．5％），死亡5例（13．：5％），其中3例死于腹腔动脉破裂导致的不可控制大出血，2例死于多器官功能衰竭合并严重感染。结论不稳定性骨盆骨折行急诊外固定架治疗，能迅速完成骨折的复位固定，恢复骨盆容积，减少出血，维持血流动力学稳定，能提高抢救成功率，降低休克及病死率，是不稳定性骨盆骨折早期治疗的一种有效方法。

Objective To investigate the meaning of early treatment of unstable pelvic fractures by simple anterior pelvic external fixation （SAPEF） under the damage control guidance. Methods The clinical data of 37 cases of pelvic frature with instabe hemodynamic who were temporary fixed with SAPEF were retrospectively analyzed. The changes of shock rate, heart rate, mean arterial pressure and shock index were observed before and after the external fixation implantation. Results All 37 cases were given the antishock therapy actively, 32 patient（86.5% ） were rescued ssuccessfully, 5 cases died （ 13.5 % ） , of which three patients died ,3f uncontrollable bleeding caused by abdominal artery rupture, 2 patients died of multiple organ failure combined with severe infections. Conclusions External fixator in early period for unstable pelvic fi＇acrures, can quickly complete the fractures fixed reset, restore the pelvic volume, reduce bleeding, keep the hemodynamic stability, improve the success rate and reduce the shock rate and mortality, is an effective method for unstable pelvic fractures in early treatment.