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老年患者因髂耻坐支骨折导致盆腔内出血引起血流动力学不稳定的研究。

Study of hemodynamic instability due to intrapelvic hemorrhage as a consequence of ilioischiopubian branch fractures in geriatric patients.

作者信息

Molinero Montes M, Fernández Álvarez C, Fernández-Valdés Fernández J M

机构信息

Hospital Universitario Central de Asturias, Oviedo, Asturias, España.

Hospital Universitario Central de Asturias, Oviedo, Asturias, España.

出版信息

Rev Esp Cir Ortop Traumatol. 2022 May-Jun;66(3):223-226. doi: 10.1016/j.recot.2021.02.005. Epub 2021 Jun 18.

Abstract

INTRODUCTION

Pelvic branch fractures are a common feature in old people which are usually treated conservatively. Massive hemorrhage is a strange complication that can compromise the patient's life. The objective of this study is to determine the incidence and possible risk factors of massive arterial injury in fractures of pelvic branches due to low energy trauma in patients over 65 years old.

CLINICAL CASE

Observational study of 142 patients diagnosed with pelvic branch fracture, We analyzed the age, sex, anatomical location, hemoglobin, need for hospital admission, complementary diagnostic test, complications and hospital stay.

RESULTS

All those ilioisquiopubial fractures complicated with massive bleeding (4 patients) were located in the Nakatani area I in close relationship with the obturator artery, internal pudendal artery and the Corona Mortis. All patients needed supraselective embolization for hemorrhagic control. Three of the patients were taking anticoagulants.

DISCUSSION

The 2,8% of patients with pelvic branch fractures may suffer a hemorrhagic complication. Be able to establish possible risk factors such a medication or anatomical location can help us identify these patients and carry out closer surveillance.

摘要

引言

骨盆支骨折是老年人的常见病症,通常采用保守治疗。大出血是一种罕见的并发症,可能危及患者生命。本研究的目的是确定65岁以上患者因低能量创伤导致骨盆支骨折时大出血性动脉损伤的发生率及可能的危险因素。

临床病例

对142例诊断为骨盆支骨折的患者进行观察性研究,分析了患者的年龄、性别、解剖位置、血红蛋白、住院需求、辅助诊断检查、并发症及住院时间。

结果

所有合并大出血的髂耻坐骨骨折(4例)均位于中谷I区,与闭孔动脉、阴部内动脉及死亡冠密切相关。所有患者均需进行超选择性栓塞以控制出血。其中3例患者正在服用抗凝剂。

讨论

2.8%的骨盆支骨折患者可能发生出血并发症。能够确定诸如药物治疗或解剖位置等可能的危险因素有助于我们识别这些患者并进行更密切的监测。

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