复杂髋臼骨折后侧手术入路损伤臀上动脉的处理  

Treatment of Injury of Superior Gluteal Artery in Operation of Complex Acetabulum Fracture Through Posterior Approach

作　　者：周东生[1] 王永会[1] 穆卫东[1] 王伯珉[1] 王鲁博[1] 

机构地区：[1]山东大学山东省立医院创伤骨科,山东省济南市250021

出　　处：《中国骨与关节损伤杂志》2007年第3期198-200,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨复杂髋臼骨折后侧手术入路损伤臀上动脉的原因、诊断手段和治疗方法。方法回顾性分析1998年6月～2004年9月收治的6例复杂髋臼骨折后侧手术入路致臀上动脉损伤的患者。结果4例转入病例中2例为臀上动脉浅支撕裂,1例为臀上动脉出梨状肌上孔处损伤,1例未发现搏动性出血点。2例缝扎损伤的臀上动脉浅支,1例腹膜外入路结扎臀上动脉。笔者手术组损伤的2例采用腹膜外入路,结扎臀上动脉。结论臀上动脉浅支的损伤容易被忽视,术后臀部血肿是其表现。臀上动脉出梨状肌上孔处的损伤可以导致致命的大出血,必须紧急处理,一般经腹膜外入路结扎臀上动脉。Objective To explore the pathogenesis, diagnosis and therapeutic of the complex acetabulum fracture through the posterior approach. Methods methods of broken superior gluteal artery in the operation Six patients hospitalized from June 1998 to September 2004 were reviewed and studied. Results Of the 4 patients from other hospitals after the operation on acetabulum fracture, 2 superficial branches of superior gluteal artery were broken, 1 superior gluteal artery was broken in superior piriform aperture and the pulsatile blooding was not found in one patient. Two superficial branches were transfixed and 1 superior gluteal artery was ligated through the extraperitoneal approach. The superior gluteal artery in two patients from our operating group was ligated through the extraperitoneal approach. Condusion Broken superficial branches of superior gluteal artery could be easily neglected. The hematoma appeared postoperatively. Broken superior gluteal artery in superior piriform aperture can induce the fatal hematorrhea. The hematorrhea must be urgently treated and the superior gluteal artery is usually ligated through the extraperitoneal approach.

关 键 词：髋臼骨折 臀部动脉 诊断 治疗 

分 类 号：R529.2[医药卫生—内科学]