躯干结合部严重创伤的院前止血技术进展

Progress of pre-hospital hemostasis strategies for life-threatening hemorrhage after major torso trauma

腹盆股结合部创伤大出血尚缺乏公认的可以广泛推广的院前有效止血措施,结合部止血带、复苏性主动脉腔内球囊阻断术和体外近端腹主动脉压迫术等技术经过培训容易掌握、操作快速简便,但容易移位、损坏而影响止血效果;复苏性主动脉腔内球囊阻断术止血效果确切,但需专业设备和专业人员,且存在严重并发症可能;体外近端腹主动脉压迫术能快捷实施,无需设备、经济,但止血效果受施救者和被救助者等多种因素影响。通过对上述各项技术的不断优化和改进、因地制宜的应用是躯干结合部严重创伤大出血院前止血措施的合理选择。

There is no consensus about the optimal pre-hospital hemostasis strategies for life-threatening hemorrhage after major abdominal-pelvic-femoral trauma.Junctional tourniquet,resuscitative endovascular balloon occlusion of the aorta(REBOA)and proximal external aortic compression(PEAC)are easily to be conducted,but are easy to shift,damage and affect the effect of hemostasis.REBOA has effective hemostasis effect,but requires professional equipment and professionals,and also has serious complications;PEAC can be quickly implemented without equipment,but the hemostasis effect is affected by many factors such as the rescuer and the rescued person.Through the continuous optimization and improvement of the above technologies,junctional tourniquet,REBOA and PEAC could control hemorrhage effectively if applied properly and individually according to pre-hospital care circumstances.