经动脉导管髂内动脉栓塞与暂时性腹主动脉阻断治疗骨盆骨折动脉出血的疗效比较

目的：比较经动脉导管髂内动脉栓塞与暂时性腹主动脉阻断治疗骨盆骨折动脉出血的疗效。方法选取2003年10月至2012年1月由笔者所在三单位联合提供的应用经动脉导管髂内动脉栓塞方法治疗的48例骨盆骨折动脉出血患者（A 组）与应用暂时性腹主动脉阻断方法治疗的10例骨盆骨折动脉出血患者（B 组），分析比较两类方法治疗后两组患者输血量、住重症加强护理病房（ICU）时间、生存例数。结果 A 组患者输血量（18.56±8.21）U，住 ICU 时间（8.04±4.25）d，16例患者死亡（其中1例死于创伤性休克，2例死于多器官功能障碍综合征，10例死于弥散性血管内凝血，3例死于急性呼吸窘迫综合征），生存率67%；B 组患者输血量（20.00±7.29）U，住 ICU 时间（12.00±6.08）d，2例患者死于创伤性休克，生存率80%。两组患者输血量、住 ICU 时间比较，差异均无统计学意义（t =-0.376、-1.906，P 均〉0.05），生存率比较差异无统计学意义（χ^2=0.000， P 〉0.05）。结论经动脉导管髂内动脉栓塞方法和暂时性腹主动脉阻断方法治疗骨盆骨折动脉出血疗效相近，应根据临床具体情况合理选用。

Comparison of transcatheter arterial embolization and temporary occlusion of abdominal aorta

Objective To compare the outcome of transcatheter arterial embolization versus temporary occlusion of abdominal aorta. Methods The study enrolled forty-eight patients who had received transcatheter arterial embolization（ Group A）and ten patients who had received temporary occlusion of abdominal aorta（Group B）for arterial hemorrhage of pelvic fracture from October 2003 to January 2012. The amount of blood transfusion,duration of intensive care unit（ ICU）and the survival cases were compared between two groups. Results Group A included amount of blood transfusionthere（18. 56 ± 8. 21）U, duration of intensive care unit（12. 00 ± 6. 08）days and 16 patients died,which included one died from traumatic shock,2 died of multiple organ dysfunction of syndrome,10 died of disseminated intravascular coagulation and 3 died of acute respiratory distress syndrome,The survival rate was 67% . Group B amount of＆amp;nbsp;blood transfusion（20. 00 ± 7. 29）U,duration of intensive care unit（12. 00 ± 6. 08）days and 2 died,which included two died of traumatic shock,The survival rate was 80% . The two groups showed no statistical differences（P 〉 0. 05）,which are amount of blood transfusion（t = - 0. 376）,duration of intensive care unit（t = - 1. 906）,survival rate（ χ^2 = 0. 000）. Conclusion Transcatheter arterial embolization or temporary occlusion of abdominal aorta are similar in pelvic arterial hemorrhage treated successfully. Thereby,one of them is selected according to the clinical case.