血管介入栓塞在经髂腹股沟入路手术治疗骨盆不稳定骨折中的应用

目的:探讨血管介入栓塞技术在止血和减少术中出血联合早期经髂腹股沟入路切开复位内固定治疗骨盆不稳定骨折中的应用价值。方法:对27例不稳定骨盆骨折患者急症行血管介入栓塞患侧髂内动脉,术后5~8 d行髂腹股沟入路切开复位内固定术。结果:全部患者均一次性栓塞成功,平均止血时间为8 min,无一例再出血。手术平均时间150 min,术中平均输血250 ml。无感染、血管神经损伤等手术并发症。术后随访6~24月,骨折均愈合,Majeed骨折评价:优14例,良8例,可5例。结论:血管介入栓塞在骨盆不稳定骨折治疗中可以有效控制骨盆骨折出血,同时较少后期手术中的出血;髂腹股沟入路骨折复位直观,操作方便,在骨盆不稳定骨折手术中值得推广。

Application of interventional embolization therapy in treatment of unstable pelvic fracture through ilioinguinal approach

Objective： To explore the clinical significance of interventional embolization therapy in treatment of unstable pelvic fracture through ilioinguinal route operation. Methods： From July 2004 to June 2009, emergency interventional embolization therapy of internal lilac artery of suffer side were performed in 27 patients for a variety of unstable pelvic fracture. After 5 to 8 days of interventional therapy, open reduction and internal fixation through ilioinguinal route were performed. Results： All patients were embolized successfully. The mean hemostasia time was 8 minutes and no patient rebleeded. The mean operation time was 150 minutes and the mean transfusion amount was 250ml. There was no severe complications after operation such as infections and injuries of blood vessel or nerves. All fracture healed after 6 to 24 months follow-up. There were 14 cases of excellent effect,8 cases of fine and 5 cases of common effect through Majeed fracture evaluation. Conclusion： The application of interventional embolization in unstable pelvic fracture can effectively control the hemorrhage of pelvic fracture and can effective- ly reduce bleeding in later stage operation. Through ilioinguinal route operation can make reduction of fracture direct and convenient and should be generalized in unstable pelvic fracture.