不同类型骨盆骨折与大出血的临床相关性研究

Clinical correlation of different types of pelvic fractures and massive hemorrhage

目的探讨不同类型骨盆骨折与血管损伤大出血的临床相关性。方法共纳入85例骨盆骨折患者,其中合并血管损伤大出血的患者36例,给予患者积极治疗,判断不同类型骨盆骨折与血管损伤大出血的临床相关性。结果最常见的骨盆骨折合并大出血为APCⅡ型及Ⅲ型患者(发现率分别为10.6%及9.4%),骨盆骨折最易损伤臀上动脉;在不同类型骨盆骨折中,APC骨盆骨折患者更容易合并有大出血的发生(发生率为58.3%),且其最易损伤臀上动脉,出血量Ⅲ型>Ⅱ型>Ⅰ型。LC型骨盆骨折患者最易损伤闭孔动脉;出血量Ⅲ型>Ⅱ型>Ⅰ型。VS型骨盆骨折患者最易损伤臀上动脉及髂内外动脉,出血量较大。CM型骨盆骨折患者最易损伤臀上动脉;出血量最大。结论最常见的骨盆骨折合并大出血为APCⅡ型及Ⅲ型患者,骨盆骨折最易损伤臀上动脉;在不同类型骨盆骨折中,APC骨盆骨折患者更容易合并有大出血的发生。

【Objective】 To investigate the clinical correlation of different types of pelvic fractures and massive hemorrhage.【Methods】 Participants included 85 patients with pelvic fractures,of 36 cases combined the blood vessel damage with massive hemorrhage,patients were treated actively,different types of pelvic fractures and blood vessel damage of massive bleeding clinical correlation were judged.【Results】 The most common pelvic fractures with massive hemorrhage were APC Ⅱand the type Ⅲ patients（found rate was 10.6% and 9.4%,respectively）,pelvic fractures the most easily to damage the buttock artery;In different types of pelvic fractures,APC pelvic fracture patients are more likely to happen with the massive hemorrhage（a rate of 58.3%）,and the most likely to damage the buttock artery,blood loss typeⅢ typeⅡ typeⅠ.LC type pelvic fracture patients most likely to damage closed pore artery;The bleeding type ⅢⅡ type typeⅠ.VS type pelvic fracture patients in the most easily hip and iliac artery damage internal and external artery,blood loss is bigger.CM type pelvic fracture patients in the most easily damage buttock artery;The biggest amount of blood loss.【Conclusions】 The most common pelvic fractures with massive hemorrhage are APCⅡ and the type Ⅲ patients,pelvic fractures the most easily to damage the buttock artery;In different types of pelvic fractures,APC pelvic fracture patients are more likely to happen with the massive hemorrhage.