低位腹主动脉球囊临时阻断在复杂髋臼骨折手术中的应用

Application of Intermittent Balloon Occlusion of the Lower Abdominal Aorta in Surgical Treatment of Complicated Acetabular Fractures

目的评价在复杂髋臼骨折早期切开复位内固定术中应用低位腹主动脉球囊临时阻断控制出血的效果.方法 43例Judet-Letournel分型为VI-X型的新鲜髋臼骨折.研究组18例,术中均使用低位腹主动脉球囊临时阻断控制出血.对照组25例,术中未使用特殊方法控制出血.对手术时间、术中出血量、异体输血量、髋臼复位情况Matta评分、术后6个月功能Harris评分进行比较.结果研究组手术时间短、术中出血少、异体输血少,差异有统计学意义(P<0.05).术后髋臼复位Matta评分、术后6个月髋关节功能Harris评分差异无统计学意义(P>0.05).结论复杂髋臼骨折早期手术中应用低位腹主动脉球囊临时阻断控制出血,其创伤小、操作简单,能有效减少术中出血量,缩短手术时间,减少异体输血,是一项值得进一步研究及推广的技术.

Objective To evaluate the efficiency of using intermittent balloon occlusion of the lower abdominal aorta during open reduction and internal fixation of complex acetabular fractures for hemorrhage control. Methods The study included 43 patients of fresh acetabular fractures with Judet-Letournel type VI-X. Study group included 18 cases in which the intermittent balloon occlusion of the lower abdominal aorta technology was used in open reduction and internal fixation of acetabular fractures to control hemorrhage. Control group included 25 cases in which no special method was adopted to control hemorrhage during surgeries. Duration of surgery, the volume of intraoperative hemorrhage, allogeneic blood transfusion, post-operative Matta score and post-operative Harris score were compared in two groups. Results In the study group, the duration of surgery was shorter and the volume of intraoperative hemorrhage and allogeneic blood transfusion were less than those in the control group, which is statistically different （P〈0.05） . Concerning post-operative Matta score and post-operative Harris score, there was no significant difference in the two groups （P〉0.05） .Conclusion Using intermittent balloon occlusion of the lower abdominal aorta in surgical treatment of complicated acetabular fractures helps to reduce hemorrhage effectively and to shorten the operating time and decrease the usage of allogeuic blood. It is well worthy of promotion.