Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Orthopedics, Liuyang people's hospital, Liuyang, China.
J Invest Surg. 2020 Jun;33(5):468-473. doi: 10.1080/08941939.2018.1516837. Epub 2018 Nov 5.
It is difficult to treat delayed acetabular fractures due to massive blood loss during operation. Temporary balloon occlusion of the abdominal aorta was introduced into sacral tumor surgery to reduce intraoperative hemorrhage. The aim of this study was to investigate the effect of this method on reduction of intraoperative blood loss and analyze the complications of this technique in the treatment of delayed acetabular fracture. We retrospectively reviewed 43 patients with delayed acetabular fracture who were surgically treated through combined approaches. Nineteen patients underwent temporary balloon occlusion of the abdominal aorta; 10 patients had type B fracture and 9 patients had type C fracture according to the Müller AO classification. The remaining 24 patients were classified into a control group; 14 patients had type B fracture and 10 patients had type C fracture. Surgical time, intraoperative blood loss, blood transfusion, satisfactory reduction rate, and functional recovery were recorded and compared between two groups. Merle d'Aubigné and Postel scoring was applied to evaluate the patients. The patients treated with intra-aortic balloon occlusion had a shorter surgical time ( = 0.008), less intraoperative blood loss ( = 0.005), and less transfused blood units ( = 0.001). No complications caused by balloon occlusion. No significant difference were observed in the outcomes and the complications related to acetabular fractures between two groups. Temporary balloon occlusion of the abdominal aorta is a reliable technique to control bleeding for the surgery of delayed acetabular fracture.
治疗髋臼延迟骨折比较困难,因为手术过程中会大量失血。在骶骨肿瘤手术中引入了腹主动脉临时球囊阻断技术,以减少术中出血。本研究旨在探讨该方法对减少术中出血量的效果,并分析该技术在治疗髋臼延迟骨折中的并发症。
我们回顾性分析了 43 例采用联合入路手术治疗的髋臼延迟骨折患者。19 例行腹主动脉临时球囊阻断术,其中 Müller AO 分型 B 型 10 例,C 型 9 例。其余 24 例患者归入对照组,其中 B 型 14 例,C 型 10 例。记录并比较两组患者的手术时间、术中出血量、输血量、满意复位率和功能恢复情况。采用 Merle d'Aubigné 和 Postel 评分进行评估。
主动脉内球囊阻断组手术时间更短( = 0.008),术中出血量更少( = 0.005),输血量更少( = 0.001)。球囊阻断无并发症。两组患者在髋臼骨折相关的结果和并发症方面无显著差异。
腹主动脉临时球囊阻断是治疗髋臼延迟骨折控制出血的可靠技术。