From the Faculty of Medicine McGill University, Montreal, Que. (Paradis); the Trauma Program, McGill University Health Centre, Montreal, Que, (Bekdache, Bracco, Grushka, Razek, Lasry, Beckett); and the Royal Canadian Medical Services, Montreal, Que. (Beckett).
Can J Surg. 2019 Apr 1;62(2):142-144. doi: 10.1503/cjs.007618.
Noncompressible hemorrhagic control remains one of the most challenging areas in damage control medicine and continues to be a leading cause of preventable death. For decades, emergency thoracotomy or laparotomy and aortic cross clamping have remained the gold standard intervention. Recently, there has been a movement toward less invasive techniques for noncompressible hemorrhagic control, such as resuscitative endovascular balloon occlusion of the aorta (REBOA). The REBOA technique involves inflation of an endovascular balloon within the abdominal aorta proximal to the vascular injury to temporarily inhibit bleeding. Although the literature is robust on this new technique, skepticism remains about whether REBOA is superior to aortic cross clamping, as it has been associated with complications including organ and limb ischemia, limb amputation, femoral aneurysm, and thrombosis.
非压迫性出血控制仍然是损伤控制医学中最具挑战性的领域之一，并且仍然是可预防死亡的主要原因。数十年来，急诊开胸或剖腹手术和主动脉阻断一直是金标准干预措施。最近，人们开始采用创伤更小的技术来控制非压迫性出血，例如复苏性血管内球囊阻断主动脉（REBOA）。REBOA 技术涉及在腹主动脉靠近血管损伤处充气一个血管内球囊，以暂时抑制出血。尽管该新技术的文献资料丰富，但对于 REBOA 是否优于主动脉阻断仍然存在怀疑，因为它与包括器官和肢体缺血、肢体截肢、股动脉瘤和血栓形成在内的并发症有关。
