Pizanis A, Pohlemann T, Burkhardt M, Aghayev E, Holstein J H
Department of Trauma, Hand, and Reconstructive Surgery, University of Saarland, Kirrberger Strasse 1, 66421 Homburg, Germany.
Injury. 2013 Dec;44(12):1760-4. doi: 10.1016/j.injury.2013.07.009. Epub 2013 Aug 2.
Emergency devices for pelvic ring stabilization include circumferential sheets, pelvic binders, and c-clamps. Our knowledge of the outcome of these techniques is currently based on limited information.
Using the dataset of the German Pelvic Trauma Registry, demographic and injury-associated characteristics as well as the outcome of pelvic fracture patients after sheet, binder, and c-clamp treatment was compared. Outcome parameters included transfusion requirement of packed red blood cells, length of hospital stay, mortality, and incidence of lethal pelvic bleeding.
Two hundred seven of 6137 (3.4%) patients documented in the German Pelvic Trauma Registry between April 30th 2004 and January 19th 2012 were treated by sheets, binders, or c-clamps. In most cases, c-clamps (69%) were used, followed by sheets (16%), and binders (15%). The median age was significantly lower in patients treated with binders than in patients treated with sheets or c-clamps (26 vs. 47 vs. 42 years, p=0.01). Sheet wrapping was associated with a significantly higher incidence of lethal pelvic bleeding compared to binder or c-clamp stabilization (23% vs. 4% vs. 8%). No significant differences between the study groups were found in sex, fracture type, blood haemoglobin concentration, arterial blood pressure, Injury Severity Score, the incidence of additional pelvic packing and arterial embolization, need of red blood cell transfusion, length of hospitalisation, and mortality.
The data suggest that emergency stabilization of the pelvic ring by binders and c-clamps is associated with a lower incidence of lethal pelvic bleeding compared to sheet wrapping.
Level III.
骨盆环稳定的紧急装置包括环形床单、骨盆固定带和C形夹。目前我们对这些技术效果的了解基于有限的信息。
利用德国骨盆创伤登记处的数据集，比较了环形床单、固定带和C形夹治疗后骨盆骨折患者的人口统计学和损伤相关特征以及治疗效果。效果参数包括浓缩红细胞的输血需求、住院时间、死亡率和致命性骨盆出血的发生率。
2004年4月30日至2012年1月19日期间在德国骨盆创伤登记处记录的6137例患者中，有207例（3.4%）接受了环形床单、固定带或C形夹治疗。在大多数情况下，使用C形夹（69%），其次是环形床单（16%）和固定带（15%）。使用固定带治疗的患者中位年龄显著低于使用环形床单或C形夹治疗的患者（分别为26岁、47岁和42岁，p=0.01）。与固定带或C形夹稳定相比，环形床单包裹导致致命性骨盆出血的发生率显著更高（分别为23%、4%和8%）。在研究组之间，性别、骨折类型、血红蛋白浓度、动脉血压、损伤严重程度评分、额外盆腔填塞和动脉栓塞的发生率、红细胞输血需求、住院时间和死亡率方面未发现显著差异。
数据表明，与环形床单包裹相比，使用固定带和C形夹对骨盆环进行紧急稳定与较低的致命性骨盆出血发生率相关。
三级。
