Vardon F, Harrois A, Duranteau J, Geeraerts T
Pôle anesthésie-réanimation, équipe d'accueil « Modélisation de l'agression tissulaire et nociceptive », université Toulouse 3 Paul-Sabatier, centre hospitalier universitaire de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 09, France.
Département d'anesthésie-réanimation chirurgicale, centre hospitalier universitaire de Bicêtre, hôpitaux universitaire Paris-Sud, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
Ann Fr Anesth Reanim. 2014 May;33(5):344-52. doi: 10.1016/j.annfar.2014.03.008. Epub 2014 May 13.
Pelvic trauma care is complex since it is frequently associated with multiple injuries and may lead to dramatic and uncontrollable haemorrhage. After pelvic trauma, the mortality, around 8 to 10%, is mainly related to severe pelvic hemorrhage but also to extrapelvic injuries (thoracic, abdominal or brain injuries). It is therefore crucial to manage pelvic trauma in specialized trauma center. The initial trauma assessment aims to determine the role of the pelvic injury in hemorrhage to define the therapeutic strategy of pelvic trauma care (arterial embolisation/pelvic ring stabilisation). This review was performed with a systematic review of the literature; it describes the pelvic fracture pathophysiology, and the efficacy and safety of haemostatic procedures and with their respective indications. A decision making algorithm is proposed for the treatment of trauma patients with pelvic fracture.
骨盆创伤的治疗很复杂，因为它常常与多发伤相关，且可能导致严重且难以控制的出血。骨盆创伤后，死亡率约为8%至10%，主要与严重的骨盆出血有关，但也与骨盆外损伤（胸部、腹部或脑部损伤）有关。因此，在专业创伤中心处理骨盆创伤至关重要。初始创伤评估旨在确定骨盆损伤在出血中所起的作用，以明确骨盆创伤治疗策略（动脉栓塞/骨盆环稳定术）。本综述通过对文献进行系统回顾得出；它描述了骨盆骨折的病理生理学、止血程序的有效性和安全性及其各自的适应证。文中还提出了一种针对骨盆骨折创伤患者的治疗决策算法。
