髋臼骨折合并臀上动脉损伤1例分析  

Analysis on one case with acetabular fracture combined with superior gluteal artery injury

作　　者：闫奇[1,2] 李杰[3] 金权赫 余也 徐波[1] 朱亚[1] 徐鹏[1] 穆卫东[1] 

机构地区：[1]山东大学附属省立医院创伤骨科,山东济南250021 [2]山东中医药大学第二临床医学院,山东济南250014 [3]山东省滕州市中心人民医院急诊科,山东滕州277500

出　　处：《中国医药导报》2017年第12期176-178,共3页China Medical Herald

基　　金：国家自然科学基金资助项目(81171708;81401786)

摘　　要：臀上动脉损伤通常并发于髋臼骨折或髋关节后脱位,损伤发生后常常在局部形成创伤性假性动脉瘤,患侧臀部肿胀并可见皮下瘀斑,其治疗方法多样。本例臀上动脉损伤后局部形成假性动脉瘤,并无臀部肿胀或瘀斑等典型体征,而术中大量出血,术野内被血液覆盖,创腔内无法找到血管断端,使用纱布填塞加压止血无效,手术机动性地选择带导丝的儿童用8号导尿管阻断患侧髂总动脉,获得满意的止血效果,手术得以顺利进行。使用本方法可以提高臀上动脉损伤诊出率,且应对术中动脉出血简单有效,能够降低休克风险。Injury of superior gluteal artery is often secondary to acetabular fractures or posterior dislocation of hip joint, which can be closely followed by a traumatic pseudoaneurysm at local, hip swelling and ecchymosis can also be found in affected parts of these cases, and various treatment modalities can be chosen. In this case, pseudoaneurysm was formed after superior gluteal artery injury, with no typical signs, such as hip swelling and ecchymosis, which resulted in excessive intraoperative hemorrhage, and the operation field was soon covered by pouring blood, the broken ends of the vessel couldn＇t be reached, and gauze packing didn＇t work. A flexible decision was made to occlude the common iliac artery with children＇s catheter, which carries a piece of guide wire, and the hemostatic effect was satisfying, then the operation was proceeded successfully. This method can improve the diagnosis rates of superior gluteal artery injury, which is simple and effective to reply the intranperativearterial hemorrhage, and it can decrease the risk of shock.

关 键 词：髋臼骨折 后柱骨折 臀上动脉 出血[ 

分 类 号：R683.3[医药卫生—骨科学]