医学临床研究
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医学临床研究  2022, Vol. 39 Issue (5): 686-689    DOI: 10.3969/j.issn.1671-7171.2022.05.013
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经导管血管造影栓塞联合外固定术治疗Tile C型骨盆骨折伴失血性休克的临床疗效
张强, 丁涛*
延安市人民医院骨科三病区,陕西 延安 716000
Clinical Value of Transcatheter Angiographic Embolization Combined with External Fixation in the Treatment of Tile C Pelvic Fracture with Hemorrhagic Shock
ZHANG Qiang, Ding Tao
Department of Orthopaedics, Yan'an People's Hospital, Yan'an Shaanxi, 716000
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摘要 【目的】探讨经导管血管造影栓塞联合外固定术治疗Tile C型骨盆骨折伴失血性休克的临床价值。【方法】回顾性分析2013年3月至2021年8月在本院诊治的102例Tile C型骨盆骨折伴失血性休克患者的临床资料,根据治疗方案不同分为观察组(n=53)和对照组(n=49),其中观察组经导管血管造影栓塞后行外固定术,对照组行外固定术后经导管血管造影栓塞。比较两组患者治疗期间的病死率;抗休克治疗中去甲肾上腺素使用量、输血量及休克纠正时间;治疗前及治疗4 h后检测血乳酸水平;血清炎性反应及氧化应激反应指标水平;栓塞及外固定架相关并发症发生率。【结果】观察组病死率低于对照组,其差异有统计学意义(χ2=4.274,P<0.05);观察组抗休克治疗中去甲肾上腺素使用量、输血量及休克纠正时间均少于对照组(P<0.05);治疗后,两组患者的血乳酸水平较治疗前均降低,且观察组低于对照组(P<0.05);两组治疗后血清高敏C反应蛋白(hs-CRP)水平较治疗前均降低,超氧化物歧化酶(SOD)水平较治疗前均升高(P<0.05)。【结论】经导管血管造影栓塞后行外固定术应用于Tile C型骨盆骨折伴失血性休克的治疗中,有助于降低患者的病死率,减少输血量,缩短休克纠正时间,降低代谢性酸中毒风险。
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张强
丁涛
关键词 骨盆骨/损伤骨折/并发症骨折/外科学休克,出血性/并发症栓塞,治疗性骨折固定术    
Abstract:【Objective】 To investigate the clinical value of transcatheter angiographic embolization combined with external fixation in the treatment of Tile C pelvic fracture with hemorrhagic shock. 【Methods】 The clinical data of 102 patients with Tile C pelvic fracture with hemorrhagic shock treated in our hospital from March 2013 to August 2021 were retrospectively analyzed. According to different treatment schemes, they were divided into observation group (n=53) and control group (n=49). The observation group underwent external fixation after transcatheter angiographic embolization, and the control group underwent transcatheter angiographic embolization after external fixation. The mortality during treatment, the amount of norepinephrine used in anti shock treatment, the amount of blood transfusion and the time of shock correction, the level of blood lactic acid before and 4 hours after treatment, the level of serum inflammatory response and oxidative stress response, and the incidence of complications related to embolization and external fixator were compared between the two groups. 【Results】 The mortality of the observation group was lower than that of the control group, and the difference was statistically significant (χ2=4.274, P<0.05); The amount of norepinephrine used in the observation group was less than that in the control group (P<0.05); After treatment, the level of blood lactic acid in the two groups was lower than that before treatment, and the level of blood lactic acid in the observation group was lower than that in the control group (P<0.05); The levels of serum high-sensitivity C-reactive protein (hs-CRP) and superoxide dismutase (SOD) in the two groups were lower than those before treatment (P<0.05). 【Conclusion】 External fixation after transcatheter angiographic embolization in the treatment of Tile C pelvic fracture with hemorrhagic shock is helpful to reduce the mortality, reduce the amount of blood transfusion, shorten the shock correction time and reduce the risk of metabolic acidosis.
Key wordsPelvic Bones/IN    Fractures, Bone/CO    Fractures, Bone/SU    Shock, Hemorrhagic/CO    Embolization, Therapeutic    Fracture Fixation
收稿日期: 2022-04-02     
中图分类号:  R683.3  
通讯作者: *E-mail: jjyy300002022@163.com   
引用本文:   
张强, 丁涛. 经导管血管造影栓塞联合外固定术治疗Tile C型骨盆骨折伴失血性休克的临床疗效[J]. 医学临床研究, 2022, 39(5): 686-689.
ZHANG Qiang, Ding Tao. Clinical Value of Transcatheter Angiographic Embolization Combined with External Fixation in the Treatment of Tile C Pelvic Fracture with Hemorrhagic Shock. JOURNAL OF CLINICAL RESEARCH, 2022, 39(5): 686-689.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.05.013     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I5/686
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