骨盆骨折大出血的治疗现状  

Treatment status of pelvic fracture with massive hemorrhage

作　　者：孙君军 康婧超 张俊[1] 李兴军 卓翔 SUN Junjun;KANG Jingchao;ZHANG Jun;LI Xingjun;ZHUO Xiang(Department of Emergency Surgery,Sinopharm Dongfeng General Hospital Affiliated to Hubei University of Medicine,Sinopharm Dongfeng General Hospital,Hubei Province,Shiyan 442004,China;Department of Anesthesia,Sinopharm Dongfeng General Hospital Affiliated to Hubei University of Medicine,Sinopharm Dongfeng General Hospital,Hubei Province,Shiyan 442004,China)

机构地区：[1]湖北医药学院附属国药东风总医院国药东风总医院急诊外科,湖北十堰442004 [2]湖北医药学院附属国药东风总医院国药东风总医院麻醉科,湖北十堰442004

出　　处：《中国当代医药》2025年第7期194-198,共5页China Modern Medicine

摘　　要：严重的骨盆骨折常合并大量失血,因局部解剖复杂、出血位置深、盆腔重要脏器多、血管神经丰富,加之失血造成的凝血功能异常,可导致骨盆骨折引起的失血难以控制,死亡率居高不下。骨盆骨折合并大出血治疗方式各异,其核心是先恢复骨盆环的稳定性、缩小盆腔容积,从而尝试稳定循环,降低相关并发症发生率。对于各种治疗方式,目前尚无金标准;且多方式联合治疗,优化治疗流程、损伤控制性外科概念已成为共识,在骨盆骨折合并大出血的治疗中显得越来越重要。本文将综合国内外文献,对骨盆兜带、骨盆外固定、腹膜外填塞、介入栓塞及复苏性主动脉球囊阻断这五种治疗方法及其适应证及局限性进行系统阐释。Severe pelvic fractures are often accompanied by massive blood loss.Due to complex local anatomy,deep bleeding location,many important pelvic organs,rich blood vessels and nerves,and abnormal coagulation function caused by blood loss,the blood loss caused by pelvic fractures can be difficult to control,and the mortality rate is high.The treatment of pelvic fracture complicated with massive hemorrhage is different,the core of which is to restore the stability of the pelvic ring and reduce the pelvic volume,so as to try to stabilize the circulation and reduce the incidence of related complications.There is no gold standard for all types of treatment.In addition,the concept of multi-mode combined treatment,optimization of treatment flow and damage control surgery has become a common understanding,which is becoming more and more important in the treatment of pelvic fracture complicated with massive hemorrhage.In this paper,the indications and limitations of five treatment methods,including pelvic girder,pelvic external fixation,extrapitoneal tamponade,interventional embolization and resuscitative aortic balloon occlusion are systematically explained based on domestic and foreign literature.

关 键 词：骨盆骨折 出血 治疗方法 综述 并发症 

分 类 号：R274.1[医药卫生—中医骨伤科学]