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新型骨盆稳定器(T-POD®)对不稳定骨盆骨折骨盆容积减少和血流动力学稳定性的影响。

Effect of a new pelvic stabilizer (T-POD®) on reduction of pelvic volume and haemodynamic stability in unstable pelvic fractures.

机构信息

Department of Surgery - Division of Trauma Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

Injury. 2010 Dec;41(12):1239-43. doi: 10.1016/j.injury.2010.03.013.

Abstract

BACKGROUND

Pelvic fractures, often the result of high energy blunt trauma, are associated with severe morbidity and mortality. A new pelvic stabilizer (T-POD®) provides secure and effective simultaneous circumferential compression of the pelvis.

METHODS

In this study we describe 15 patients with a prehospital untreated unstable pelvic fracture with signs of hypovolaemic shock with the T-POD®. Before and 2 min after applying the T-POD®, heart rate and blood pressure were measured. An X-ray before and directly after applying the T-POD® was made to measure the effect on reduction in symphyseal diastasis.

RESULTS

Application of the T-POD® reduced the symphyseal diastasis with 60% (p = 0.01). The mean arterial pressure (MAP) increased significant from 65.3 to 81.2 mm Hg (p = 0.03) and the heart rate declined from 107 beats per minute to 94 (p = 0.02). Out of ten patients in whom the circulatory response before and after the T-POD® was recorded, seven were good responders, one had a transient response and two responded poor.

CONCLUSION

In the acute setting, the T-POD® device has a clear compressive effect on the pelvic volume in unstable pelvic fractures. The T-POD® is therefore an effective and easy to use device in (temporarily) stabilizing the pelvic ring in haemodynamically unstable patients.

摘要

背景

骨盆骨折通常是高能钝性创伤的结果,与严重的发病率和死亡率相关。一种新型骨盆固定器(T-POD®)可提供安全有效的骨盆环环形同时压缩。

方法

在这项研究中,我们描述了 15 例院前未治疗的不稳定骨盆骨折患者,这些患者存在低血容量性休克的迹象,并使用 T-POD®进行治疗。在应用 T-POD®之前和之后 2 分钟,测量心率和血压。在应用 T-POD®前后拍摄 X 光片,以测量耻骨联合分离的复位效果。

结果

应用 T-POD®可使耻骨联合分离减少 60%(p = 0.01)。平均动脉压(MAP)从 65.3 毫米汞柱显著增加至 81.2 毫米汞柱(p = 0.03),心率从 107 次/分钟降至 94 次/分钟(p = 0.02)。在记录 T-POD®前后循环反应的 10 例患者中,7 例为良好反应者,1 例为短暂反应者,2 例为反应不佳者。

结论

在急性情况下,T-POD®装置对不稳定骨盆骨折的骨盆容积具有明显的压缩作用。因此,T-POD®是一种有效且易于使用的装置,可在血流动力学不稳定的患者中(暂时)稳定骨盆环。

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