【摘要】 目的 探讨经导管动脉栓塞术在骨盆骨折合并大出血急救中的临床应用价值。 方法 22例骨盆骨折并发盆腔大出血休克的患者，急诊行出血动脉和(或)髂内动脉主干栓塞术，伴有肝脾破裂患者同时行肝脾动脉栓塞术。采用Seldinger技术行选择性动脉造影确定出血血管后，超选择插管至该血管，以相应栓塞材料进行栓塞，再次造影证实栓塞效果。 结果 19例患者可见明显的对比剂外溢，出血动脉为髂内动脉主干5例，臀上动脉8例，阴部内动脉或闭孔动脉4例;2例表现为髂内动脉分支中断，2例血管造影未见明显阳性表现，全部22例均在1.5h内完成栓塞治疗，术后24h内全部患者血压逐步回升至正常水平90～120/60～90mmHg。未出现严重的栓塞并发症。3例合并MODS死亡，其余都得到有效抢救而治愈。 结论 经导管动脉栓塞术是骨盆骨折大出血是一种安全、迅速、有效的急救止血手段，值得推广应用。

    关键词 骨盆骨折 后腹膜血肿 介入治疗 血管栓塞

    The acute embolization in treatment of pelvic fracture massive hemorrhage

    Ning Ye，Yin Gang，Jiang Chonghui，et al.

    Zhongshan's First Aid Center，Zhongshan，Guangdong528403.

    【Abstract】 Objective The patients of pelvic fracture massive hemorrhage caused by trauma used acute arteri-ography and transcatheter arterial embolization，to demonstrate the value of acute embolization in pelvic fracture mas-sive hemorrhage.Methods All patients were given arteriography and embolization with correlation embolism materials by seldings technique and then the angiographies were performed until there were no appearance of hemorrhage.Re-sults Expert3died of MODS and serious additional injuries ......