Boonsinsukh Thana, Maroongroge Panitpong
Department of Surgery, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhon Nayok, 26120, Thailand.
Department of Radiology, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhon Nayok, 26120, Thailand.
Ann Med Surg (Lond). 2020 May 16;55:97-100. doi: 10.1016/j.amsu.2020.04.029. eCollection 2020 Jul.
Transcatheter arterial embolization (TAE) is a useful endovascular technique for controlling hemorrhage in blunt abdominopelvic trauma without shock. However, several studies have reported that TAE is safe and effective for controlling hemorrhage in hypovolemic shock.
To evaluate the effectiveness of TAE for patients with shock from abdominopelvic trauma.
The medical records of patients with abdominopelvic trauma at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University from January 2014 to January 2019 were retrospectively reviewed. We enrolled patients with shock caused by injury to solid organs or pelvic fractures who underwent TAE.
Of the 320 patients, 14 patients with shock underwent TAE. A total of 78.6% were male. The mean age was 37.5 years. The average injury severity score was 31.3. The most common mechanism of injury was traffic accidents (85.7%). Embolization was performed for 8 liver injuries, 5 pelvic fractures and 1 splenic injury. The treatment time for TAE was approximately 47.9 ± 33.2 min. The mean length of hospital stay was 21.3 ± 15.9 days. Two patients died (14.3%). There were no embolization-related complications. A significant improvement in systolic blood pressure (p = 0.028) and a decrease in heart rate (p = 0.001), lactate concentration (p = 0.011), and crystalloid fluid (p = 0.001) and blood transfusion requirements (p = 0.002) were observed after TAE.
TAE is a safe and effective method for treating shock patients with a rapid or transient response to resuscitation. For patients who are nonresponsive to resuscitation, TAE is an additional useful option for arterial hemorrhage control in abdominopelvic trauma.
经导管动脉栓塞术（TAE）是一种用于控制钝性腹部盆腔创伤出血且无休克的有用的血管内技术。然而，多项研究报告称TAE在控制低血容量性休克出血方面是安全有效的。
评估TAE对腹部盆腔创伤性休克患者的有效性。
回顾性分析2014年1月至2019年1月在诗纳卡宁威洛大学玛哈·扎克里·诗琳通公主殿下医疗中心接受腹部盆腔创伤治疗的患者的病历。我们纳入了因实体器官损伤或骨盆骨折导致休克并接受TAE治疗的患者。
在320例患者中，14例休克患者接受了TAE治疗。其中男性占78.6%。平均年龄为37.5岁。平均损伤严重程度评分为31.3分。最常见的损伤机制是交通事故（85.7%）。对8例肝损伤、5例骨盆骨折和1例脾损伤进行了栓塞治疗。TAE的治疗时间约为47.9±33.2分钟。平均住院时间为21.3±15.9天。2例患者死亡（14.3%）。未发生与栓塞相关的并发症。TAE术后观察到收缩压显著改善（p = 0.028），心率（p = 0.001）、乳酸浓度（p = 0.011）、晶体液（p = 0.001）和输血需求（p = 0.002）均降低。
TAE是治疗对复苏有快速或短暂反应的休克患者的一种安全有效的方法。对于对复苏无反应的患者，TAE是控制腹部盆腔创伤动脉出血的另一种有用选择。
