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腹部或骨盆严重多发伤的介入治疗经验:160例分析

Interventional treatment experience in multiple injury with major abdominal or pelvic injuries: 160 cases analysis.

作者信息

Zhang Tian-Xi, Han Mei, Ye Peng, Hu Quan, Li Jia-Lin, Yin Ling, Yu An-Yong

机构信息

Department of Emergency, The First Affiliated Hospital of Zunyi Medical College, Zunyi 563003, Guizhou Province, China.

Department of Emergency, The First Affiliated Hospital of Zunyi Medical College, Zunyi 563003, Guizhou Province, China.

出版信息

Chin J Traumatol. 2018 Feb;21(1):27-29. doi: 10.1016/j.cjtee.2017.11.003. Epub 2018 Jan 31.

Abstract

PURPOSE

To observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury.

METHODS

Data of 160 multiple trauma patients with a major abdominal or pelvic injury were retrospectively analyzed. They were admitted into the Department of Emergency of the First Affiliated Hospital of Zunyi Medical College from October 2013 to April 2016. Eighty-seven patients who received emergent intervention for embolization and haemorrhage control were set as group A, including 72 males and 15 females, with an average age of (39.32 ± 14.0) years. Patients underwent emergent intervention for embolization and hemostasis. The other 73 patients who received traditional surgeries were set as group B, including 62 males and 11 females, with an average age of (38.48 ± 13.12) years. The time from admission to emergency intervention, the time of interventional embolization, transfusion during hospitalization, length of stay and prognosis were observed. The whole treatment and prognosis were compared between group A and group B.

RESULTS

In group A, the average time from admission to intervention exploration was (132.05 ± 86.80) min, the average operation time was (149 ± 49.69) min, the average hospitalization time was (18.37 ± 4.71) days, the average amount of RBC transfusion during hospitalization was (7.2 ± 4.33) units, and the mortality was 4.60% (4 patients died). The corresponding data in group B were respectively (138.95 ± 82.49) min, (183 ± 52.39) min, (22.72 ± 6.63) days, (12.23 ± 5.43) units, and 9.59% (7 cases died). There was no statistical difference in the time from admission to operation between the two groups (p > 0.05), but there was statistical difference in operation time, RBC transfusion, hospitalization time, prognosis, and mortality between the two groups (all p < 0.05).

CONCLUSION

The emergent intervention for embolization and haemorrhage control of multiple trauma patients with a major abdominal or pelvic injury and visceral organ haemorrhage has the advantages of less trauma, shorter operation time, shorter hospital stay, less blood transfusion in comparison to the traditional emergency surgeries.

摘要

目的

观察介入栓塞及控制出血在腹部或骨盆严重损伤的多发伤患者中的治疗效果。

方法

回顾性分析160例腹部或骨盆严重损伤的多发伤患者的数据。这些患者于2013年10月至2016年4月入住遵义医学院第一附属医院急诊科。87例接受紧急介入栓塞及控制出血的患者设为A组,其中男性72例,女性15例,平均年龄(39.32±14.0)岁。患者接受紧急介入栓塞及止血治疗。另外73例接受传统手术的患者设为B组,其中男性62例,女性11例,平均年龄(38.48±13.12)岁。观察从入院到紧急干预的时间、介入栓塞时间、住院期间输血情况、住院时间及预后。比较A组和B组的整体治疗及预后情况。

结果

A组从入院到介入探查的平均时间为(132.05±86.80)分钟,平均手术时间为(149±49.69)分钟,平均住院时间为(18.37±4.71)天,住院期间红细胞平均输血量为(7.2±4.33)单位,死亡率为4.60%(4例死亡)。B组相应数据分别为(138.95±82.49)分钟、(183±52.39)分钟、(22.72±6.63)天(12.23±5.43)单位,死亡率为9.59%(7例死亡)。两组从入院到手术的时间无统计学差异(p>0.05),但两组在手术时间、红细胞输血、住院时间、预后及死亡率方面存在统计学差异(均p<0.05)。

结论

对于腹部或骨盆严重损伤且内脏器官出血的多发伤患者,紧急介入栓塞及控制出血与传统急诊手术相比,具有创伤小、手术时间短、住院时间短、输血少等优点。

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