Davis F E
Am Surg. 1986 Oct;52(10):548-50.
One hundred twenty-eight pelvic fractures were reviewed. Of the 128 patients with pelvic fractures, there were seven deaths. Pelvic fractures associated with the greatest blood loss and complications were those which occurred in crush-type injuries secondary to automobile accidents or other heavy impact injuries. Unless fractures were of a crush-type with massive fractures, the amount of blood loss correlated more closely with the history of injury than it did with the x-ray appearance of pelvic fracture. A single patient in this series had greater than 45 units blood loss and exhibited many of the basic problems encountered when dealing with patients with major pelvic fractures. The case of this patient is reviewed in detail, including component therapy for massive blood loss. The prophylactic use of caval filtration or an umbrella device might be warranted in patients with massive pelvic fractures.
回顾了128例骨盆骨折病例。在这128例骨盆骨折患者中，有7例死亡。与最大失血量和并发症相关的骨盆骨折是那些继发于汽车事故或其他严重撞击伤的挤压型损伤。除非骨折是伴有大量骨折的挤压型，否则失血量与受伤史的相关性比与骨盆骨折的X线表现的相关性更密切。该系列中有1例患者失血量超过45单位，并且出现了处理严重骨盆骨折患者时遇到的许多基本问题。详细回顾了该患者的病例，包括针对大量失血的成分治疗。对于严重骨盆骨折患者，可能有必要预防性使用腔静脉滤器或伞形装置。
