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骨盆周径压缩装置有益于需要搬运的骨盆骨折患者。

Pelvic circumferential compression devices benefit patients with pelvic fractures who need transfers.

机构信息

Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.

出版信息

Am J Emerg Med. 2013 Oct;31(10):1432-6. doi: 10.1016/j.ajem.2013.06.044. Epub 2013 Aug 22.

Abstract

INTRODUCTION

Patients with pelvic fracture usually require transfers to trauma centers for additional advanced treatment. Patient safety during the transfer should always be a priority. The noninvasive pelvic circumferential compression device (PCCD) can reportedly provide a tamponade effect, which reduces hemorrhage. In the present study, we evaluated the feasibility and efficiency of PCCD in patients with pelvic fracture who required transfer to trauma centers.

MATERIALS AND METHODS

In the present study, we aimed to evaluate patients with pelvic fractures who were transferred from other hospitals. We investigated and compared the characteristics of these types of patients with and without pretransfer PCCD. We compared 2 groups (with and without pretransfer PCCD) of patients under different situations (unstable pelvic fracture, stable pelvic fracture, or indicated for transcatheter arterial embolization). We also analyzed the characteristics of patients with unstable pelvic fracture who were initially evaluated as having stable pelvic fracture primarily before being transferred.

RESULTS

During the 53-month period, we enrolled 585 patients in the study. The patients with unstable pelvic fractures who received pretransfer PCCDs required significantly fewer blood transfusions (398.4 ± 417.6 mL vs 1954.5 ± 249.0 mL, P < .001), shorter intensive care unit length of stay (LOS; 6.6 ± 5.2 days vs 11.8 ± 7.7 days, P = .024), and shorter hospital LOS (9.4 ± 7.0 days vs 19.5 ± 13.7 days, P = .006) compared with patients who did not receive the pretransfer PCCD. The stable patients who received pretransfer PCCDs required significantly fewer blood transfusions (120.2 ± 178.5 mL vs 231.8 ± 206.2 mL, P = .018) and had shorter intensive care unit LOS (1.7 ± 3.3 days vs 3.4 ± 2.9 days, P = .029) and shorter hospital LOS (6.8 ± 5.1 days vs 10.4 ± 7.6 days, P = .018) compared with patients who did not receive the pretransfer PCCD.

CONCLUSION

Pelvic circumferential compression devices benefit patients with pelvic fracture who need to be transferred to trauma centers. Pretransfer PCCDs appeared to be a feasible and safe procedure during the transfer. In discussions between the referring physicians and the receiving physicians, we recommend using pretransfer PCCDs.

摘要

简介

骨盆骨折患者通常需要转至创伤中心接受进一步的高级治疗。在转运过程中,患者的安全始终应是首要考虑因素。非侵入性骨盆环形压迫装置(PCCD)据称可提供填塞效果,从而减少出血。在本研究中,我们评估了骨盆骨折患者在转至创伤中心时使用 PCCD 的可行性和效率。

材料与方法

本研究旨在评估从其他医院转来的骨盆骨折患者。我们调查并比较了有和无预转移 PCCD 的此类患者的特征。我们比较了 2 组(有和无预转移 PCCD)不同情况下(不稳定骨盆骨折、稳定骨盆骨折或需要经导管动脉栓塞术)的患者。我们还分析了最初评估为稳定骨盆骨折但在转院前被评估为不稳定骨盆骨折的患者的特征。

结果

在 53 个月的时间内,我们共纳入了 585 名患者。接受预转移 PCCD 的不稳定骨盆骨折患者的输血量明显较少(398.4 ± 417.6 毫升比 1954.5 ± 249.0 毫升,P <.001),重症监护病房住院时间更短(6.6 ± 5.2 天比 11.8 ± 7.7 天,P =.024),医院住院时间更短(9.4 ± 7.0 天比 19.5 ± 13.7 天,P =.006)。接受预转移 PCCD 的稳定患者的输血量明显较少(120.2 ± 178.5 毫升比 231.8 ± 206.2 毫升,P =.018),重症监护病房住院时间更短(1.7 ± 3.3 天比 3.4 ± 2.9 天,P =.029),医院住院时间更短(6.8 ± 5.1 天比 10.4 ± 7.6 天,P =.018)。

结论

骨盆环形压迫装置有益于需要转至创伤中心的骨盆骨折患者。在转运过程中,预转移 PCCD 似乎是一种可行且安全的方法。在转诊医生和接收医生的讨论中,我们建议使用预转移 PCCD。

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