骨盆骨折并发失血性休克的急诊救治

Emergency treatment experience of pelvic fracture with hemorrhagic shock

目的讨论急诊救治对骨盆骨折并发失血性休克患者的意义。方法回顾分析17例骨盆骨折并发失血性休克患者的临床资料,对所有患者积极输液输血,在休克得到控制后采用Seldinger的改良技术,进行DSA造影,用明胶海绵进行动脉栓塞,栓塞后进行骨盆外固定、肢体外固定。结果 2例发生弥漫性血管内凝血导致死亡,占11.8%;7例经紧急救治后好转,占41.2%;8例经紧急救治后,发现局部皮肤、肌肉感染或坏死,其中2例盆腔脏器发生严重并发症,经对症治疗后,延期好转,占47.1%,总成功率为88.2%。结论发生骨盆骨折合并失血性休克后,进行紧急救治,输液输血,固定止血,对提高骨盆骨折生存质量,降低死亡率,是重要的措施。

Objective To explore emergency treatment significance of pelvic fracture patients with hemorrhagic shock. Methods Retrospectively analyzed 17 cases of pelvic fracture with hemorrhagic shock,all of the patients were treated by blood transfusion,used seldinger improved technology after shock had been controlled,DSA imaging,artery embolization with gelatin sponge,and after embolization,did pelvic external fixation,limb external fixation. Results Disseminated intravascular coagulation lead to 2 deaths,accounted for 11.8%;7 cases had improved after emergency treatment,accounted for 41.2%;8 cases were found local skin,muscle infection or necrosis after emergency treatment,2 cases＇ pelvic organs happened serious complications,after symptomatic treatment,the patients had delayed upturn,accounted for 47.1%. The total success rate was 88.2%. Conclusion After the pelvic fracture with hemorrhagic shock happened,emergency treatment,blood transfusion,fixed stop bleeding are important measures in improving pelvic fracture life quality,and reducing mortality.