Skitch Steven, Engels Paul T
Department of Emergency Medicine, McMaster University, Hamilton General Hospital, 6 North Wing - Room 616, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada; Department of Critical Care, McMaster University, Hamilton General Hospital, 6 North Wing - Room 616, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
Department of Critical Care, McMaster University, Hamilton General Hospital, 6 North Wing - Room 616, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada; Department of Surgery, McMaster University, Hamilton General Hospital, 6 North Wing - Room 616, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
Emerg Med Clin North Am. 2018 Feb;36(1):161-179. doi: 10.1016/j.emc.2017.08.011.
Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists). This article explores this complex clinical problem and provides a practical approach to its management.
严重骨盆创伤是一种具有挑战性的病症。骨盆会引发多灶性出血，这种出血不易通过传统手术方法（如结扎血管或切除器官）进行压迫或处理。其治疗通常需要对骨结构进行重新复位、损伤控制复苏、评估相关损伤、对检查进行分类，以及由多学科创伤专家（普通外科医生、骨科医生、血管内外科医生/介入放射科医生）进行多模式出血控制（外固定、腹膜前填塞、血管栓塞、主动脉内球囊阻断复苏术）。本文探讨了这一复杂的临床问题，并提供了一种实用的处理方法。
