摘要
目的分析动脉栓塞联合外固定术对不稳定性骨盆骨折伴出血性休克患者ISS评分及止血成功率的影响。方法选取2019年1月—2021年1月在上海中医药大学附属龙华医院接受治疗的120骨盆骨折伴出血性休克患者进行研究,对应用单纯外固定术治疗者定为对照组(60例),联合开展外固定术与动脉栓塞治疗者定为观察组(60例)。对比分析两组患者创伤严重程度(ISS)、生命体征变化情况、凝血功能及止血成功率。结果观察组治疗后ISS评分明显低于对照组(P<0.05),治疗后观察组心率、呼吸及休克指数低于对照组(P<0.05),舒张压、收缩压水平高于对照组(P<0.05);观察组与对照组比较,前者凝血酶原时间(PT)、纤维蛋白原(FIB)水平明显增高,活化部分凝血酶原时间(APTT)、凝血酶时间(TT)水平降低;观察组止血成功率(96.67%)高于对照组(86.67%),死亡率(3.33%)低于对照组(13.33%),差异有统计学意义(P<0.05)。结论联合应用动脉栓塞与外固定术对不稳定性骨盆骨折伴出血性休克患者进行治疗,可在一定程度上减轻患者的创伤程度,稳定其生命体征和血流动力学,有助于进一步提高其止血成功率,降低死亡风险。
Objective To analyze the effects of arterial embolization combined with external fixation on ISS score and success rate of hemostasis in patients with unstable pelvic fracture with hemorrhagic shock.Methods A total of 120 patients with pelvic fracture and hemorrhagic shock who were treated in our hospital from January 2019 to January 2021 were selected for this study and grouped by random number table.The control group(60 cases)received external fixation alone,and the observation group(60 cases)received external fixation combined with arterial embolization.The severity of trauma(ISS),changes in vital signs,coagulation function and success rate of hemostasis in 2 groups were compared and analyzed.Results Compared with the control group,the ISS score of the observation group was significantly lower after treatment.Compared with the control group,the heart rate,respiration and shock index of the observation group were lower after treatment,and the levels of diastolic blood pressure and systolic blood pressure were higher.Compared with the control group,PT and FIB levels in the observation group were higher,APTT and TT levels were lower;compared with the control group,the success rate of hemostasis in the observation group was higher and the mortality was lower(P<0.05).Conclusion The combined application of arterial embolization and external fixation in the treatment of patients with unstable pelvic fracture accompanied by hemorrhagic shock can alleviate the degree of trauma,stabilize the vital signs and hemodynamics of the patients,further improve the success rate of hemostasis,and reduce the risk of death.
作者
蒋云霞
莫文
左晓琳
JIANG Yun-xia;MO Wen;ZUO Xiao-lin(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《医药论坛杂志》
2021年第21期30-33,共4页
Journal of Medical Forum
关键词
动脉栓塞
外固定术
不稳定性骨盆骨折
出血性休克
ISS评分
止血成功率
Arterial embolization
External fixation
Unstable pelvic fracture
Hemorrhagic shock
ISS score
Success rate of hemostasis
