不稳定骨盆骨折急救的新进展

New progresses in the first aid for unstable pelvic fracture

骨盆骨折是常见的损伤,仅次于四肢和脊柱骨折,并发症较多,有较高的病死率。高能损伤所致骨盆骨折逐年增多,且复杂而严重,临床处理困难。既往多采取非手术治疗,如骨牵引、骨盆悬吊、石膏固定等方法,但病死率高达5%～20%,致残率为1. 9%～36. 6%。随着对骨盆骨折认识的深入,近年来主张对不稳定性骨盆骨折,采取更加积极的治疗,早期评估、损害控制复苏、血管造影栓塞等新理念降低了病死率和致残率。

Pelvic fracture is a common injury just following limb and spine fractures.Its complications are common while the mortality is relatively high.Pelvic fracture caused by high-energy injuries has increased year by year and is often featured by complicated and serious conditions and a high difficulty of clinical treatment.In the past,conservative treatments such as skeletal traction,pelvic suspension and plaster fixation were mostly adopted,but the mortality rate were as high as 5-20%and the disability rate 1.9-36.6%.With more thorough understanding of pelvic fractures,more active methods have been advocated for the treatment of unstable pelvic fractures in recent years,and new concepts such as early assessment,damage control resuscitation(DCR)and angiographic embolization have decreased the mortality and the disability rate.