摘要
目的 评价急诊骨盆外固定术对骨盆骨折伴血流动力学不稳定患者的治疗作用.方法 收集2008年1月至2013年12月诊治的56例骨盆骨折伴血流动力学不稳定患者的临床资料,比较分析56例患者骨盆外固定术前及术后24 h的血红蛋白、平均动脉压、心率、血乳酸、尿量、去甲肾上腺素用量等的变化情况.结果 56例患者骨盆外固定术后24 h,血红蛋白、平均动脉压、血乳酸、尿量、心率较术前显著改善[(109±12) g/L比(69±22) g/L、(87.8±6.5) mmHg(1 mmHg=0.133 kPa)比(55.8 ±7.7) mmHg、(6.3 ±5.1) mmol/L比(10.8±6.6)mmol/L、(35.9±9.9) ml/h比(17.6±8.4) ml/h、(84.2±15.4)次/min比(146.4±12.1)次/min],去甲肾上腺素用量显著减少[(0.8±0.2)μg/(kg·min)比(2.2 ±0.8) μg/(kg·min)],差异均有统计学意义(P<0.05或<0.01).结论 骨盆骨折伴血流动力学不稳定时,给予在床边行骨盆外固定术能迅速改善患者的休克症状,骨盆外固定术是一种安全有效的抢救方法.
Objective To evaluate the clinical effect of emergency pelvic external fixation in hemodynamically unstable patients with pelvic fracture.Methods The clinical data of 56 hemodynamically unstable patients with pelvic fracture from January 2008 to December 2013 were selected.The changes of hemoglobin,mean arterial pressure,heart rate,serum lactate,urine volume,norepinephrine dosage before and after surgery for 24 h were compared and analyzed.Results Compared with those before surgery,the levels of hemoglobin,mean arterial pressure,serum lactate,urine volume,heart rate after surgery for 24 h were significantly improved:(109 ± 12) g/L vs.(69 ±22) g/L,(87.8 ±6.5) mmHg (1 mmHg =0.133 kPa) vs.(55.8 ± 7.7) mmHg,(6.3 ± 5.1) mmol/L vs.(10.8 ± 6.6) mmol/L,(35.9 ± 9.9) ml/h vs.(17.6 ± 8.4) ml/h,(84.2 ± 15.4) times/min vs.(146.4 ± 12.1) times/min,and the norepinephrine dosage was significantly reduced:(0.8 ± 0.2) μ g/ (kg· min) vs.(2.2 ± 0.8) μ g/ (kg· min).The differences had statistical significance (P 〈 0.05 or 〈 0.01).Conclusion Bedside pelvic external fixation can rapidly improve shock symptom in hemodynamically unstable patients with pelvic fracture,which is safe and efficient.
出处
《中国医师进修杂志》
2015年第5期349-351,共3页
Chinese Journal of Postgraduates of Medicine