CAJ | 학술논문

目的评价急诊骨盆外固定术对骨盆骨折伴血流动力学不稳定患者的治疗作用.方法收集2008年1月至2013年12月诊治的56例骨盆骨折伴血流动力学不稳定患者的临床资料,比较分析56例患者骨盆外固定术前及术后24 h的血红蛋白、平均动脉压、心率、血乳酸、尿量、去甲肾上腺素用量等的变化情况.结果 56例患者骨盆外固定术后24 h,血红蛋白、平均动脉压、血乳酸、尿量、心率较术前显著改善[(109±12) g/L比(69±22) g/L、(87.8±6.5) mmHg(1 mmHg=0.133 kPa)比(55.8 ±7.7) mmHg、(6.3 ±5.1) mmol/L比(10.8±6.6)mmol/L、(35.9±9.9) ml/h比(17.6±8.4) ml/h、(84.2±15.4)次/min比(146.4±12.1)次/min],去甲肾上腺素用量显著减少[(0.8±0.2)μg/(kg·min)比(2.2 ±0.8) μg/(kg·min)],差异均有统计学意义(P＜0.05或＜0.01).结论骨盆骨折伴血流动力学不稳定时,给予在床边行骨盆外固定术能迅速改善患者的休克症状,骨盆外固定术是一种安全有效的抢救方法.
목적 평개급진골분외고정술대골분골절반혈류동역학불은정환자적치료작용.방법 수집2008년1월지2013년12월진치적56례골분골절반혈류동역학불은정환자적림상자료,비교분석56례환자골분외고정술전급술후24 h적혈홍단백、평균동맥압、심솔、혈유산、뇨량、거갑신상선소용량등적변화정황.결과 56례환자골분외고정술후24 h,혈홍단백、평균동맥압、혈유산、뇨량、심솔교술전현저개선[(109±12) g/L비(69±22) g/L、(87.8±6.5) mmHg(1 mmHg=0.133 kPa)비(55.8 ±7.7) mmHg、(6.3 ±5.1) mmol/L비(10.8±6.6)mmol/L、(35.9±9.9) ml/h비(17.6±8.4) ml/h、(84.2±15.4)차/min비(146.4±12.1)차/min],거갑신상선소용량현저감소[(0.8±0.2)μg/(kg·min)비(2.2 ±0.8) μg/(kg·min)],차이균유통계학의의(P＜0.05혹＜0.01).결론 골분골절반혈류동역학불은정시,급여재상변행골분외고정술능신속개선환자적휴극증상,골분외고정술시일충안전유효적창구방법.
Objective To evaluate the clinical effect of emergency pelvic external fixation in hemodynamically unstable patients with pelvic fracture.Methods The clinical data of 56 hemodynamically unstable patients with pelvic fracture from January 2008 to December 2013 were selected.The changes of hemoglobin,mean arterial pressure,heart rate,serum lactate,urine volume,norepinephrine dosage before and after surgery for 24 h were compared and analyzed.Results Compared with those before surgery,the levels of hemoglobin,mean arterial pressure,serum lactate,urine volume,heart rate after surgery for 24 h were significantly improved:(109 ± 12) g/L vs.(69 ±22) g/L,(87.8 ±6.5) mmHg (1 mmHg =0.133 kPa) vs.(55.8 ± 7.7) mmHg,(6.3 ± 5.1) mmol/L vs.(10.8 ± 6.6) mmol/L,(35.9 ± 9.9) ml/h vs.(17.6 ± 8.4) ml/h,(84.2 ± 15.4) times/min vs.(146.4 ± 12.1) times/min,and the norepinephrine dosage was significantly reduced:(0.8 ± 0.2) μ g/ (kg· min) vs.(2.2 ± 0.8) μ g/ (kg· min).The differences had statistical significance (P ＜ 0.05 or ＜ 0.01).Conclusion Bedside pelvic external fixation can rapidly improve shock symptom in hemodynamically unstable patients with pelvic fracture,which is safe and efficient.