Clinical comparison of three hemostatic methods for controlling pelvic fracture hemorrhoea / 中国基层医药

ABSTRACT

Objective To compare the efficiency of gauze packing , internal iliac artery ligation and tran-scatheter arterial embolization for controlling pelvic fracture hemorrhoea .Methods The clinical data of 23 consecu-tive patients with pelvic fracture hemorrhoea were retrospectively analyzed .There were 8 patients who had undergone gauze packing,6 patients undergone artery ligation ,9 patients undergone angioembolization .The ISS,the preoperative shock index ,the operation time of control the shock ,the postoperative blood transfusion ,the days in ICU after opera-tion and the complication were all recorded respectively .Results The operation time of control the shock ,the postop-erative blood transfusion and the days in ICU after operation of the packing group were ( 70.00 ±24.50 ) min, (1 050.00 ±207.02) mL and (10.12 ±1.64) d;the ligation group were (40.83 ±12.01) min,(1 800.00 ± 400.00)mL and (11.17 ±1.72)d;the angioembolization group were (91.67 ±22.64)min,(1 644.44 ±421.64) mL and (7.22 ±1.56)d.The difference between the three groups had statistical significance with the indexes above all(F=10.323,9.265,12.235,all P<0.05),and the ligation group had the shortest operation time to control the shock,the packing group had the least postoperative blood transfusion ,the angioembolization group had the shortest days in ICU after operation .There were 4 cases in the packing group suffering the infection ,the infection rates as high as 50%,one of them died on the 8d;there were one case in the ligation group died of MODS on the 11th day. Conclusion The gauze packing is a sample and effective hemostasis ,suitable for the patients with open fracture and the fist aid for pelvic fracture in the basic level hospitals;the internal iliac artery ligation can control the shock timely but the hemostatic efficacy is not better than the other two kinds of operation; the transcatheter arterial embolization has micro injury and effective hemostatic efficacy ,however ,the strong profession and the lage difficulty may delay the patients'condition .So the doctors should use the methods of hemostasis flexiblely and comprehensively .