ABSTRACT
<p><b>OBJECTIVE</b>To investigate feasibility and curative effect of superselective arterial embolization for the treatment of massive haemorrhage from pelvic fracture.</p><p><b>METHODS</b>From March 2008 to February 2016, clinical data of 65 patients with massive haemorrhage from pelvic fracture were collected and analyzed, and patients were divided into non-embolic and embolic group according to whether perform vascular thrombosis. Thirty-three patients were in non-embolic group including 26 males and 7 females aged from 21 to 64 years old with an average of(39.2±5.7) years old, the time from injury to operation ranged from 1.1 to 4.8 h with an average of (2.2±0.4) h; 12 cases were type B and 21 cases were type C according to AO/Tile classification; injury severity score (ISS) ranged from 25 to 42 with an average of (37.7±7.5); shock index score ranged from 1.7 to 2.4 with an average of 2.1±0.3; treated with blood transfusion and fluid infusion. Thirty-two patients in embolic group, including 25 males and 7 females aged from 22 to 65 years old with an average of(38.1±4.5) years old; the time from injury to operation ranged from 1.2 to 4.8 h with an average of (2.1± 0.5) h; 14 cases were type B and 18 cases were type C according to AO/Tile classification; ISS ranged from 26 to 43 with an average of 38.9±4.5; shock index score ranged from 1.6 to 2.4 with an average of 2.2±0.2; treated by blood transfusion and fluid infusion with superselective arterial embolization. Blood transfusion volume, fluid infusion volume, shock correction time and survival rate were observed and compared, effective rate of hemostasis and postoperative complications were compared.</p><p><b>RESULTS</b>Thirty-seven artery were injured in embolic group, hemostasis were controlled at 3 h after operation, and hemodynamics turned to stable. There were significant difference in blood transfusion volume, fluid infusion volume, shock correction time between non-embolic and embolic group, and embolic group performed better. Survival rate in embolic group was also better than that of non-embolic group, and had significant difference. While there was obvious differences in complications(χ²=4.03,=0.045).</p><p><b>CONCLUSIONS</b>Superselective arterial embolization for massive haemorrhage from pelvic fracture could effective hemostasis, reduce blood transfusion and fluid infusion volume and occurrence rate of shock, moreover improve survival rate and deserves promotion.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the techniques and curative effects of transcatheter artery embolization (TAE) for massive bleeding due to pelvic fractures.</p><p><b>METHODS</b>The clinical data of 92 patients with haemorrhage due to pelvic fractures from March 1998 to February 2008 were retrospectively analyzed. Among 53 patients treated conservatively such as massive transfusion and fluid infusion in the control group, 43 patients were male and 10 patients were female, ranging in age from 27 to 61 years, averaged (37.2 +/- 5.7) years. Among 39 patients who were hemodynamically unstable or had evidences of ongoing hemorrhage required TAE, 26 patients were male and 13 patients were female, ranging in age from 26 to 62 years, with a mean age of (35.3 +/- 9.5) years. The clinical date such as blood or fluid transfusion volume, shock redress time and survival rate were compared between the two groups. The hemostatic efficiency and complications of the surgery were also analyzed.</p><p><b>RESULTS</b>The average hemostasis time of TAE group was 2 hours. There were no intraoperative injuries of blood vessels, nerve or vital organs. Three patients had lower limbs numbness and 5 patients had gluteal skin redness after the operation. The blood transfusion or fluid infusion volume, shock redress time and survival rate were all significantly better than those in the conservative group.</p><p><b>CONCLUSIONS</b>TAE is an early,rapid and effective method in controlling haemorrhage due to pelvic fractures.</p>