髂内动脉断血术在血流动力学不稳定骨盆骨折急救中应用的相关问题  

Issues related to application of internal iliac artery devascularization in the emergency management of hemodynamically unstable pelvic fracture

作　　者：李辉 黄光斌 都定元 Li Hui;Huang Guangbin;Du Dingyuan(Chongqing University Central Hospital,Department of Trauma Surgery of Chongqing Emergency Medical Center,Trauma Center of Chongqing University,School of Medicine,Chongqing 400014,China)

机构地区：[1]重庆大学附属中心医院,重庆市急救医疗中心创伤外科,重庆大学医学院创伤医学中心,重庆400014

出　　处：《中华创伤杂志》2024年第7期577-584,共8页Chinese Journal of Trauma

基　　金：国家创伤区域医疗中心(委市共建)重大研究项目(jjzx2021⁃gjcsqyylzx01);重庆英才计划研究项目(cstc2022ycjh⁃bgzxm0245);重庆市科卫联合医学科研项目(2022QNXM025)。

摘　　要：血流动力学不稳定骨盆骨折是创伤致死的重要原因之一,其救治是创伤外科面临的重大挑战。髂内动脉断血术包含髂内动脉结扎术和栓塞术,两者均以阻断髂内动脉灌注为止血机制,已被证实是控制骨盆骨折大出血的有效手段。尽管如此,临床实践中对髂内动脉断血术的认识仍存在巨大差异,其在血流动力学不稳定骨盆骨折急救应用中需注意的问题尚未得到充分阐明。为此,笔者就髂内动脉断血术的有效性和安全性、应用指征及实施要点等进行重点阐述,旨在促进其在血流动力学不稳定骨盆骨折治疗中的规范应用,进而改善治疗结局。Hemodynamically unstable pelvic fracture is an important cause of trauma⁃related deaths and its treatment presents a major challenge for trauma surgery.Internal iliac artery devascularization including ligation and embolization of the internal iliac artery with occlusion of the internal iliac artery as their hemostatic mechanism,has been proved to be effective in controlling massive hemorrhage after pelvic fracture.Nevertheless,there still remain substantial differences in the understanding of internal iliac artery devascularization in clinical practice.Some and issues that should be paid attention to its emergency application in the management of hemodynamically unstable pelvic fracture have not been fully elucidated.To this end,the authors emphasized the efficacy and safety of internal iliac artery devascularization,its indications,and key points in implementation,aiming to promote its standardized application in the treatment of hemodynamically unstable pelvic fracture,thus improving treatment outcomes.

关 键 词：骨盆 损伤 休克 创伤性 髂内动脉 结扎术 栓塞 治疗性 

分 类 号：R683.3[医药卫生—骨科学]