髂内动脉断血术在创伤急救中的应用  

Application of hypogastric arterial ligation and angioembolization i n pelvic injuries

作　　者：高劲谋[1] 胡平[1] 田显扬[1] 李昌华[1] 赵山弘[1] 杨俊[1] 林曦[1] 

机构地区：[1]重庆市急救医疗中心创伤科,重庆400014

出　　处：《中华急诊医学杂志》2005年第8期676-678,共3页Chinese Journal of Emergency Medicine

摘　　要：目的探讨髂内动脉结扎和动脉造影栓塞对骨盆及盆底创伤出血的治疗效果。方法14年间结扎或栓塞治疗的58例患者分为A组(前7年)和B组(后7年)。对损伤情况、治疗方法和结果作回顾性分析。结果58例患者中,骨盆骨折51例、臀或肛周锐器伤7例。A组17例均做结扎术。B组41例中,27例结扎、12例栓塞(5例为骨盆手术前预防性栓塞)、2例先后结扎和栓塞。骨盆及盆底创伤出血患者的总病死率为13·8%(8/58);A、B组病死率分别为35·3%、4·9%(P<0·01),且与前后期患者治疗前失血量不同有关。结论髂内动脉结扎或栓塞是骨盆和盆底创伤有效的止血手段,应争取在失血过多出现消耗性凝血病前施行。预防性栓塞可减少骨盆手术中出血。Objective To evaluate the efficacy and safety of hypogastric arterial ligation(HAL)and angioembolization(A E)in plevic injuries.Methods The pantients undergoing HAL or AE for their pelvic injures during the past 14 y ears were studied retrospectively.The cases were divided into two groups:group A,the patients in the first 7 years;and group B,the patients in the latter 7 yea rs.Results In the all 58 patients,there were 51 with pelvic fracture,and 7 were gluteal or crissal penetrating injury.All the 17 patients in group A underwent HAL.Of group B,27 patients received HAL,12 patients received AE with 5 as a prophylexis befo re the pelvic fracture operation,and the remaining 2 underwent both HAL and AE.T he mortality was 13.8%(8/58).In group A and group B,the mortality were 35.3% a nd 4.9%,respectively(P<0.01), Which was associated with volume of blood loss before therapy between tho former and the latter.Conclusion HAL and AE could be effectiv ely and safely used for controlling bleeding after pelvic injuries.These procedu res should be carried out before consumptive coagulopathy because of exsanguiati on.As prophylaxis before the operation for pelvic fracture,AE is also an availab le option.

关 键 词：髂内动脉断血术 创伤 急救措施 骨盆 

分 类 号：R641[医药卫生—外科学]