Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage
Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage
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DOI：
10.1097/00005373-199709000-00001
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发表时间：
1997-09-01
影响因子：
--
通讯作者：
Reed, JF
中科院分区：
文献类型：
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作者：
Agolini, SF;Shah, K;Reed, JF
目的：回顾性分析严重骨盆骨折不稳定患者栓塞止血的成功率，计算栓塞时间，并确定血管造影的收益率。设计：回顾性分析5年内因骨盆骨折入住I级创伤中心的患者。材料和方法：对损伤严重程度评分、年龄、血压、凝血酶原时间/部分凝血活酶时间、骨盆骨折类型、死亡率、到达血管造影室的时间、实现栓塞的时间，测量和主要结果：806例骨盆骨折患者中，35例接受了骨盆血管造影，15例（1.9%）需要栓塞。所有患者均成功栓塞，无持续出血导致死亡。最初不稳定患者的血管造影率为64%。死亡者的平均年龄和初始血流动力学不稳定性明显更大。从到达创伤室到到达血管造影室的时间范围为50 - 1，140分钟，在血管造影室进行栓塞的时间范围为50 - 140分钟，平均时间为90分钟，到达后3小时内栓塞的患者生存率明显较高。只有一小部分骨盆骨折患者需要栓塞治疗，但当使用时，栓塞可以100%有效。年龄、栓塞时间和初始血流动力学不稳定似乎是生存的重要因素。
Objective: To review the success rate of embolization in stopping hemorrhage for unstable patients with severe pelvic fractures, to calculate the time to achieve embolization, and to determine the yield from angiography.Design: Retrospective review of patients admitted to a Level I trauma center with pelvic fractures during a 5-year period.Materials and Methods: Charts were reviewed for Injury Severity Score, age, blood pressure, prothrombin time/partial thromboplastin time, pelvic fracture type, mortality, time to reach the angiography suite, time to achieve embolization, and mechanism of injury.Measurements and Main Results: Of 806 patients admitted with pelvic fractures, 35 underwent pelvic angiography, and 15 (1.9%) required embolization. Embolization was successful for all patients, No deaths resulted from ongoing hemorrhage. Angiography yield in initially unstable patients was 64 %. The mean age and initial hemodynamic instability were significantly greater in nonsurvivors. The time from arrival in the trauma bay to arrival in the angiography suite ranged from 50 to 1,140 minutes, and the time spent in the angiography suite performing embolization ranged from 50 to 140 minutes, with an average time of 90 minutes, Patients, who were embolized within 3 hours of arrival had a significantly greater survival rate.Conclusion: Only a small percentage of patients,vith pelvic fractures require embolization, but when it is used, embolization can be 100% effective. Age, time to achieve embolization, and initial hemodynamic instability appear to be important factors in survival.