摘要
目的探讨带囊骨盆带对猪血流动力学不稳定型骨盆骨折的止血效果。方法取24头12个月龄雌性巴马小型猪,显露髂外血管并制造"开书样"骨折,然后随机分为4组(n=6):对照组(C组)仅暴露髂外血管,不做处理;血管破坏组(D组)破坏髂外血管,不做后续处理;简易骨盆带组(T1组)破坏髂外血管后使用简易骨盆带固定;带囊骨盆带组(T2组)破坏髂外血管后使用带囊骨盆带固定。比较4组猪的40 min生存率、膀胱压力、乳酸峰值、总出血量、出血率、输液率和血管造影结果等。结果4组猪实验前的基线指标比较差异均无统计学意义(P>0.05),具有可比性。T2组猪的40 min生存率为83.3%(5/6),显著高于D组和T1组猪[0%(0/6)、0%(0/6)],差异均有统计学意义(P<0.05)。C组、D组、T1组及T2组猪的膀胱压力分别为(6.67±1.03)、(5.83±1.94)、(6.00±1.55)、(6.00±1.10)mmHg,差异无统计学意义(P>0.05)。D组、T1组及T2组猪的总出血量分别为(1198.0±182.9)、(1252.0±148.4)、(1150.0±125.7)mL,差异无统计学意义(P>0.05)。T2组猪的乳酸峰值[(2.26±0.24)mmol/L]显著低于D组[(5.00±0.60)mmol/L]和T1组猪[(3.86±0.57)mmol/L],出血率和输液率[(25.83±5.49)、(26.00±4.69)mL/min]也显著低于D组[(83.50±19.85)、(71.50±29.11)mL/min]和T1组猪[(54.17±15.59)、(54.17±8.98)mL/min],差异均有统计学意义(P<0.05)。T2组猪动静脉造影均显示有造影剂外渗,且动脉较为明显,但与D组猪相比,外渗速度明显减慢。结论在猪模型中,带囊骨盆带对血流动力学不稳定型骨盆骨折造成的血管损伤具有止血效果,且其效果优于简易骨盆带。
Objective To evaluate the hemostatic effects of our self-designed pelvic band with inflatable balloon in a swine model of hemodynamically unstable pelvic fracture.Methods"Open-book like"fractures were created with the external iliac blood vessels exposed in 2412-month-old female Bama miniature pigs which were randomly divided into 4 groups(n=6).Group C(the control group)was subjected to no treatment other than exposure of the external iliac blood vessels,group D to no treatment following destruction of the external iliac blood vessels,group T1 to fixation with simple pelvic band after destruction of the external iliac blood vessels,and group T2 to fixation with our self-designed pelvic band with inflatable balloon after destruction of the external iliac blood vessels.The 4 groups were compared in terms of 40-min survival rate,bladder pressure,peak lactate value,total blood loss,bleeding rate,infusion rate,and angiographic images.Results There was no significant difference in the baseline indexes among the 4 groups before experiment,showing comparability(P>0.05).The 40-min survival rate in group T2 was 83.3%(5/6),significantly higher than that in groups D and T1[0%(0/6)and 0%(0/6)](P<0.05).There were no significant differences among groups C,D,T1 and T2 in bladder pressure[(6.67±1.03)mmHg,(5.83±1.94)mmHg,(6.00±1.55)mmHg,and(6.00±1.10)mmHg]or in total blood loss among groups D,T1 and T2[(1,198.0±182.9)mL,(1,252.0±148.4)mL,and(1,150.0±125.7)mL](all P>0.05).The peak lactate value in group T2[(2.26±0.24)mmol/L]was significantly lower than that in group D[(5.00±0.60)mmol/L]and group T1[(3.86±0.57)mmol/L],and the bleeding rate and infusion rate in group T2[(25.83±5.49)mL/min and(26.00±4.69)mL/min]were also significantly lower than those in group D[(83.50±19.85)mL/min and(71.50±29.11)mL/min]and group T1[(54.17±15.59)mL/min and(54.17±8.98)mL/min](all P<0.05).Angiography showed contrast agent extravasation in group T2,especially from the artery,but the extravasation speed in group T2 was significantly slower than that in group D.Conclusion In a swine model of hemodynamically unstable pelvic fracture,our self-designed pelvic band with inflatable balloon has a definite hemostatic effect on vascular injury which is better than that of a simple pelvic band.
作者
李放
金小高
储勤军
周占锋
邴海龙
白京岳
娄君鸽
张勇
林琳
连鸿凯
Li Fang;Jin Xiaogao;Chu Qinjun;Zhou Zhanfeng;Bing Hailong;Bai Jingyu;Lou Junge;Zhang Yong;Lin Lin;Lian Hongkai(Department of Orthopaedics,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Department of Anesthesiology and Perioperative Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Research of Trauma Center,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Interventional Department,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Department of Ultrasound Imaging,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2023年第9期812-818,共7页
Chinese Journal of Orthopaedic Trauma
关键词
骨盆
骨折
血流动力学
出血
带囊骨盆带
血管造影术
猪
Pelvis
Fractures,bone
Hemodynamics
Hemorrhage
Pelvic band with inflatable balloon
Angiography
Swine