骨盆骨折伴髂股血管损伤治疗

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1、骨盆骨折伴骼股血管损伤治疗［摘要］回顾我科收治的10例骨盆骨折伴骼股血管损伤的急救策略及治疗，探讨如何提高此类损伤患者的抢救成功率及治疗效果。10例骨盆骨折伴股动脉损伤患者经抗休克及止血处理均抢救成功，其中4例保肢成功；4例初期保肢成功，此后由于出现肾衰竭或肢体坏死等并发症，行骯关节离断术；2例由于伤肢毁损严重，急症截肢。对伴有股血管损伤的骨盆骨折患者，接诊后应该及时评估伤情，积极抗休克治疗，尽早修复损伤的股血管。股血管修复适用于血管壁无明显挫伤者，对直接修复困难者加以血管移植。对血管严重损伤患者，可应用血管移植或重建术。如果患者双下肢均有股血管损伤，一条下肢毁损严重

2、需要截肢，可以取截肢侧的血管修复保肢侧损伤的股血管［关键词］骨盆骨折；骼股血管损伤；创伤急救；休克［中图分类号］R683［文献标识码］B［文章编号］1673-9701(2016)34-0064-03ThetreatmentofpelvicfracturewithiliacvascularinjuryLIWeihongZHANGQingbinWANYonggangDepartmentofOrthopedics,ZhuchengCityPeople，sHospitalAffiliatedtoWeifangMedicalCollege,Zhucheng262200,Chin

3、a[Abstract]Thefirst-aidstrategyandtreatmentof10patientswithiliacpelvicfracturesandfemoralvascularinjuriestreatedinourdepartment,todiscusshowtoimprovethesuccessrateandthetherapeuticeffectofthesepatients・The10casesofpelvicfractureswithfemoralarteryinjuryweresuccessfullytreatedviathetreatm

4、entswithanti-shockandhemostasis,including4patientswithlimbsalvagesuccess；4caseshadearlylimbsalvagesuccess,thenhipjointamputa/tionwasoperatedonthemsincerenalfailure,limbnecrosisandothercomplicationsoccurred；and2casesreceivedacuteamputationduetoseverelimbinjury.Forpatientswithpelvicfractu

5、reassociatedwithfemoralvascularinjury,atimelyassessmentofinjury,activelyanti—shocktreatmentandearlyrepairofdamagedbloodvesselsshouldbetakenatadmission.Femoralvascularrepairisapplicabletothecaseswhosevascularwallhasnoobviouscontusion,tothecaseswhomhavedifficultiesindirectrepair,vasculart

6、ransplantationisapplied・Vasculartransplantationorreconstructioncanbeappliedforseverevascularinjury.Ifbothlowerlimbsofpatientshavefemoralvascularinjury,onewithextremelydamagerequiringamputation,thebloodvesselsoftheamputationlimbcanbetakentorepairtheinjuredfemoralarteryofthelimbforsalvage

7、・[Keywords]Pelvicfracture；Iliacvascularinjury；Traumafirstaid；Shock❷乐氐墓桥棍钦曲萇嘶❷制较复杂，常为多发伤，骨盆骨折伴发骼股血管损伤的发生率较低，一旦发生会出现失血性休克等严重的并发症。本文回顾我科2007年5月〜2012年5月间骨盆骨折伴骼股血管损伤患者的治疗，探讨各种治疗方法的可行性1资料与方法1.1一般资料选择2007年5月〜2012年5月期间收治的骨盆骨折伴骼股血管损伤患者10例，男8例，女2例；最小年龄18岁，最大年龄56岁，平均35.3岁；车祸伤7例，重物砸伤1例，高处坠