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经导管动脉栓塞治疗骨盆骨折相关大出血后的并发症

[Complications following transcatheter arterial embolization for massive hemorrhage associated with pelvic fracture].

作者信息

Hori A

机构信息

Department of Radiology, Faculty of Medicine, Kagoshima University.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1991 Apr 25;51(4):365-74.

PMID:1648707
Abstract

Complications of internal iliac artery embolization were studied in 21 patients. The 9 male and 12 female patients were 12-70 years old (average 39). This procedure was carried out for control of hemorrhage due to pelvic fracture. Embolization was performed using gelfoam cubes (1-2 mm) for main internal iliac artery or its branches subselectively. In the earlier series, steel coils were placed in the internal iliac artery routinely after gelfoam embolization. In the group of 9 men, 4 male had impotence and 5 had no change in sexual function. As a possible post embolization neurological damage, 4 patients had sensory disturbance and 8 patients had gait disturbance. Three patients had dysuria and one of them had also difficulty in defecation. All these complications following internal iliac artery embolization are suspected to be due to associated injuries and varied effect of traumatic pelvic fracture than a result of the vascular occlusion. Percutaneous transcatheter therapeutic embolization is a safe and effective procedure of choice for controlling massive bleeding associated with pelvic fracture.

摘要

对21例患者的髂内动脉栓塞并发症进行了研究。9例男性和12例女性患者年龄在12至70岁之间(平均39岁)。该手术用于控制骨盆骨折引起的出血。使用明胶海绵方块(1 - 2毫米)对髂内动脉主干或其分支进行选择性栓塞。在早期系列中,明胶海绵栓塞后常规在髂内动脉放置钢圈。在9名男性患者中,4例出现阳痿,5例性功能无变化。作为栓塞后可能的神经损伤,4例患者有感觉障碍,8例患者有步态障碍。3例患者有排尿困难,其中1例还伴有排便困难。髂内动脉栓塞后的所有这些并发症被怀疑是由于相关损伤以及创伤性骨盆骨折的不同影响,而非血管闭塞所致。经皮经导管治疗性栓塞是控制与骨盆骨折相关的大出血的一种安全有效的选择方法。

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