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暂时性髂内动脉球囊闭塞术治疗难治性骨盆骨折出血

Temporal intrailiac balloon occlusion for the treatment of intractable pelvic fracture hemorrhage.

作者信息

Ishida Kenichiro, Noborio Mitsuhiro, Shimahara Yumiko, Nishimura Tetsuro, Sogabe Taku, Ieki Yohei, Ehara Naoki, Sadamitsu Daikai

机构信息

Traumatology and Critical Care Medical Center Osaka National Hospital Osaka Japan.

Department of Emergency Japanese Red Cross Society Kyoto Daiichi Hospital Kyoto Japan.

出版信息

Acute Med Surg. 2015 Oct 20;3(2):195-198. doi: 10.1002/ams2.167. eCollection 2016 Apr.

DOI:10.1002/ams2.167
PMID:29123782
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5667397/
Abstract

CASE

A 48-year-old schizophrenic man sustained multiple injuries following a fall. Unstable pelvic fractures were diagnosed in the emergency department. The patient's hemodynamic status was stabilized following bilateral internal iliac artery embolization using a gelatin sponge. However, recurrent bleeding and an expanding retroperitoneal hemorrhage occurred 1 h after transcatheter arterial embolization.

OUTCOME

Using temporal intrailiac balloon occlusion, with preperitoneal gauze packing, the patient's hemodynamic status was stabilized in the intensive care unit. No complications were observed following transcatheter arterial embolization and balloon occlusion.

CONCLUSIONS

Temporary intrailiac balloon occlusion is a rapid and safe treatment for refractory pelvic hemorrhage, which can be administered simultaneously with other treatments including preperitoneal gauze packing and external fixation.

摘要

病例

一名48岁的精神分裂症男性在跌倒后多处受伤。急诊科诊断为不稳定骨盆骨折。使用明胶海绵对双侧髂内动脉进行栓塞后，患者的血流动力学状态得以稳定。然而，经导管动脉栓塞术后1小时出现复发性出血和腹膜后出血扩大。

结果

在重症监护病房，通过暂时性髂内球囊闭塞并进行腹膜前纱布填塞，患者的血流动力学状态得以稳定。经导管动脉栓塞和球囊闭塞术后未观察到并发症。

结论

暂时性髂内球囊闭塞是治疗难治性骨盆出血的一种快速且安全的方法，可与包括腹膜前纱布填塞和外固定在内的其他治疗方法同时进行。

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Evaluation of the safety and feasibility of resuscitative endovascular balloon occlusion of the aorta.主动脉复苏性血管内球囊阻断术的安全性和可行性评估。
J Trauma Acute Care Surg. 2015 May;78(5):897-903; discussion 904. doi: 10.1097/TA.0000000000000614.
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Nonoperative management of hemodynamically unstable abdominal trauma patients with angioembolization and resuscitative endovascular balloon occlusion of the aorta.对血流动力学不稳定的腹部创伤患者采用血管栓塞和主动脉复苏性血管内球囊阻断术进行非手术治疗。
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J Trauma Acute Care Surg. 2014 Feb;76(2):374-9. doi: 10.1097/TA.0000000000000094.
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Comparison between laparotomy first versus angiographic embolization first in patients with pelvic fracture and hemoperitoneum: a nationwide observational study from the Japan Trauma Data Bank.剖腹探查术与血管造影栓塞术治疗骨盆骨折合并腹腔积血患者的比较：来自日本创伤数据库的全国性观察研究。
Scand J Trauma Resusc Emerg Med. 2013 Dec 3;21:82. doi: 10.1186/1757-7241-21-82.
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Unstable pelvic ring injury with hemodynamic instability: what seems the best procedure choice and sequence in the initial management?不稳定骨盆环损伤伴血流动力学不稳定：初始处理中，哪种方法选择和顺序最好？
Orthop Traumatol Surg Res. 2013 Apr;99(2):175-82. doi: 10.1016/j.otsr.2012.12.014. Epub 2013 Feb 23.
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Use of temporary partial intrailiac balloon occlusion for decreasing blood loss during open reduction and internal fixation of acetabular and pelvis fractures.在髋臼和骨盆骨折切开复位内固定术中使用临时髂内部分球囊阻断以减少失血。
J Orthop Trauma. 2012 Jun;26(6):e54-7. doi: 10.1097/BOT.0b013e31822c51b8.
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Repeat transcatheter arterial embolization for the management of pelvic arterial hemorrhage.重复经导管动脉栓塞术治疗盆腔动脉出血
J Trauma. 2009 Feb;66(2):429-35. doi: 10.1097/TA.0b013e31817c969b.
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Temporary endovascular balloon occlusion of the bilateral internal iliac arteries for control of hemorrhage during laparoscopic-assisted myomectomy in a nulligravida with a large cervical myoma.在一名未孕且患有巨大宫颈肌瘤的患者行腹腔镜辅助子宫肌瘤切除术时，采用双侧髂内动脉血管内临时球囊闭塞术控制出血。
Fertil Steril. 2009 Mar;91(3):935.e5-9. doi: 10.1016/j.fertnstert.2008.09.040. Epub 2008 Nov 6.
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