Treatment of massive bleeding after pelvic fracture with temporary occlusion of abdominal aorta
10.3760/cma.j.issn.0253-2352.2011.05.013
- VernacularTitle:腹主动脉球囊阻断术治疗骨盆骨折大出血
- Author:
Lianxin LI
;
Dongsheng ZHOU
;
Lubo WANG
;
Bomin WANG
;
Weidong MU
;
Fu WANG
- Publication Type:Journal Article
- Keywords:
Pelvis;
Fractures,bone;
Hemorrhage;
Hemostasis,surgical
- From:
Chinese Journal of Orthopaedics
2011;31(5):487-490
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of temporary occlusion of abdominal aorta in the treatment of massive bleeding after pelvic fracture.Methods From May 2003 to May 2010,temporary occlusion of abdominal aorta was performed for 23 patients with massive bleeding after pelvic fracture.There are 15 male and 8 female patients with a mean age of 32 years (range,17-62 years).The mechanisms of injury included traffic accidents in 17 cases,falls in 4,engine injury in 1 and crash injury in 1 case.According to AO classification,4 cases were of type B2,4 of type B3,2 of type B3,1 of type C1,4 of type C2,and 12 of type C3.After aorta occlusion,the internal iliac vessel was ligated and the bleeding sites were tamponed.The fractures of pelvis were reduced.External fixation was used in 17 cases and screws and plates were used to fixation in 6 cases.Results All cases were rescued successfully.The average volume of blood transfusion was 4000 ml (range,1500-8500 ml).Intraoperative self-blood transfusion was performed in 14 patients.The average volume of self-blood transfusion was 1500 ml (range,700-5000 ml).Twenty-one patients were followed;the duration of follow-up was 26 months (range,5-36 months).The functional results were excellent in 11 cases,good in 4,fair in 3 and poor in 2 according to Majeed scores system.Complications included 2 cases of infection,1 of lower limb deep venous thrombosis,1 of malreduction of sacroiliac joint,and 1 of malunion of pelvic fracture.No complication was found due to the aorta occlusion or the internal iliac vessel ligation.Conclusion Temporary occlusion of abdominal aorta was an efficient and quick method in the treatment of massive bleeding after pelvic fracture.
