在一名钝性大腿近端截肢后即将发生心脏骤停的患者中，紧急改良应用主动脉内球囊阻断进行止血。
Hemostasis with emergently modified application of intra-aortic balloon occlusion in a patient with impending cardiac arrest following blunt proximal thigh amputation.
作者信息
Uchida Kotaro, Homma Hiroshi, Oda Jun, Yukioka Tetsuo, Nagai Noriko, Mishima Shiro, Ohta Shoichi
机构信息
Department of Emergency and Critical Care Medicine Tokyo Medical University Tokyo Japan.
出版信息
Acute Med Surg. 2014 Jul 14;2(1):69-71. doi: 10.1002/ams2.62. eCollection 2015 Jan.
CASE
A 30-year-old woman had her left thigh run over by a train. We tried to compress the left femoral area to control the arterial bleeding, but bleeding continued from the stump and injured soft tissue. The application of a tourniquet bandage also failed because of the limited remaining thigh. She developed impending cardiac arrest. As the left femoral arterial pulsation was still palpable, we inserted an intra-aortic balloon occlusion catheter percutaneously. The hemorrhage from the stump region decreased rapidly. She was transferred to an operating room to carry out surgical hemostasis, and it was confirmed with deflation of the balloon in the common iliac artery.
OUTCOME
There was no complication of the skin or soft tissue at the surgical site caused by impaired circulation, and her consciousness fully recovered.
CONCLUSION
We report the successful control of bleeding by the emergently modified application of intra-aortic balloon occlusion in the left common iliac artery.
病例
一名30岁女性的左大腿被火车碾压。我们试图压迫左股部区域以控制动脉出血，但残端和受伤的软组织仍持续出血。由于剩余大腿部分有限，使用止血带包扎也未成功。她出现了即将发生心脏骤停的情况。由于仍可触及左股动脉搏动，我们经皮插入了一根主动脉内球囊阻断导管。残端区域的出血迅速减少。她被转移至手术室进行手术止血，通过髂总动脉球囊放气得以确认止血成功。
结果
手术部位的皮肤或软组织未因循环受损而出现并发症，她的意识完全恢复。
结论
我们报告了通过紧急改良应用主动脉内球囊阻断左髂总动脉成功控制出血的案例。
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