暂时性腹主动脉阻断术在骨盆骨折大出血急救中的应用  

Treatment of massive bleeding after pelvic fracture with temporary occlusion of abdominal aorta

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

机构地区：[1]山东省立医院创伤骨科,济南250021

出　　处：《中华创伤骨科杂志》2007年第10期912-914,共3页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨股动脉插管暂时性腹主动脉阻断术治疗严重骨盆骨折大出血的急救方法。方法2003年5月-2007年5月，对14例复杂性骨盆骨折后3—6h内经多通道输血3000mL左右、输液3000mL左右而生命体征不能维持的患者采用股动脉插管暂时性腹主动脉阻断术治疗，同时行髂内血管结扎，腹膜后止血处理。结果14例骨盆骨折大出血患者均被成功抢救。出血量最多者为8000mL，平均回输血量为4000mL。患者术后病情平稳，降低了因骨盆骨折大出血而造成的一系列并发症的发生，取得满意的治疗效果。结论骨盆骨折大出血的早期急救是降低死亡率的主要环节，应该积极、正确、动态、迅速评估患者的伤情。不能过于保守，以免延误病情。错失抢救时机。股动脉插管暂时性腹主动脉阻断术是有效的止血方法之一。Objective To explore the efficacy of temporary occlusion of the abdominal aorta in the treatment of massive bleeding after pelvic fracture. Methods From May 2003 to May 2007, temporary occlusion of the abdominal aorta was perfumed on 14 patients with massive bleeding after pelvic fracture. because their blood pressure was unstable after blood transfusion of more than 3000 mLo After aorta occlusion, the internal iliac vessel was ligated and the bleeding sites post peritoneum were tamponed. Results All the 14 patients were saved successfully. The largest blood loss was 8000 mL and the mean was 4000 mL. Conditions of the patients were stabilized and complications due to massive hemorrhea were con- trolled. Conclusion Temporary occlusion of the abdominal aorta is efficient in the rescue of patients with massive bleeding after pelvic fracture.

关 键 词：骨盆 骨折 出血 阻断疗法 

分 类 号：R686[医药卫生—骨科学]