陈旧性髋臼骨折开放复位内固定术中腹主动脉球囊的应用

Application of Abdominal Aortic Balloon in the Open Reduction and Internal Fixation for Delayed Acetabular Fractures

目的探讨陈旧性髋臼骨折开放复位内固定术中应用腹主动脉球囊降低失血量的效果。方法回顾性分析2013年6月~2018年6月手术治疗的32例陈旧性髋臼骨折患者的临床资料,均行K-L入路髋臼骨折复位内固定术。根据术中是否应用腹主动脉球囊分为观察组(n=15)和对照组(n=17)。记录并比较两组患者的手术相关指标、骨折复位情况、临床疗效及并发症发生情况。结果所有患者均随访超过1年。观察组手术时间、术中出血量及异体输血量均明显低于对照组(P<0.05)。术后末次随访,两组骨折复位优良率、临床疗效优良率及并发症发生率比较差异均无统计学意义(P>0.05)。结论对于陈旧性髋臼骨折患者,腹主动脉球囊阻断有助于减少术中出血量及异体输血量,是控制术中出血的有效方法。

Objective To explore the effect of intra-aortic balloon in reducing blood loss during the surgery of open reduction and internal fixation for delayed acetabular fractures.Methods 32 patients with delayed acetabular fractures who underwent the surgery of open reduction and internal fixation via K-L approach from June 2013 to June 2018 were enrolled and analyzed retrospectively.The patients were divided into the ob-servation group(n=15)and control group(n=17)according to intra-aortic balloon applied or not during the operation.The surgical related indicators,fracture reduction,clinical effect and complications rate were recorded and compared between the two groups.Results All patients were followed up more than 1 year.The op-eration time,intra-operative blood loss volume and allogeneic blood transfusion volume were significantly lower in the observation group than those in the control group(P<0.05).At the last follow-up,there was no significant difference in the excellent rate of fracture reduction and clinical effect and the incident rate of post-operative complication between the two groups(P>0.05).Conclusion The application of abdominal aortic balloon occlusion can reduce the intra-operative blood loss and allogeneic blood transfusion,and is an effective method to control intra-operative bleeding during the surgery for patients with delayed acetabular fractures.