复苏性主动脉球囊阻断在创伤急救中的应用进展

Progress on application of resuscitative endovascular balloon occlusion of the aorta in trauma emergency

大出血是创伤早期死亡的最主要原因,明确出血部位、迅速控制出血对于改善创伤出血的救治效果至关重要。复苏性主动脉球囊阻断(REBOA)是将球囊导管置入主动脉后使用生理盐水充盈球囊,阻止血液流入主动脉远端,减少阻断位置以远部位的活动性出血,同时增加心脏后负荷和近端主动脉压,提高心脏和脑的灌注量,为进一步救治争取更多时间。但由于医务人员的认识程度、操作上的技术难度以及预期效果与实际结果的偏差,至今还存在一些争议。本文就REBOA的原理、在创伤急救中的应用效果、存在的问题与发展趋势进行综述。

Massive bleeding is the main cause of death in the early stage of trauma.Identifying the location of bleeding and controlling bleeding quickly are very important to improve the treatment effect of traumatic bleeding.Resuscitation endovascular balloon occlusion of the aorta(REBOA)is to fill the balloon with normal saline after inserting the balloon catheter into the aorta to prevent blood from flowing into the distal aorta and reduce active bleeding from the distal part of the aorta.At the same time,it can increase the cardiac afterload and proximal aortic pressure,increase the perfusion volume of heart and brain,and earn more time for further treatment.However,due to the cognitive degree of medical staff,the technical difficulty in operation and the deviation between the expected effect and the actual result,there is still controversy.This article reviews the principle,application effect,existing problems and developmental trend of REBOA in trauma emergency.