球囊阻断技术在下肢大血管断裂中的临床应用

Application of temporary balloon block on lower abdominal aorta during operation in patients with lower limb large vascular injury

关键词:  腹主动脉球囊阻断  下肢  大血管损伤

Key words:  abdominal aorta balloon block  lower limbs  large vascular injury

摘要:

目的探讨低位腹主动脉球囊阻断技术在下肢大血管断裂患者中的临床应用价值。方法回顾性分析15例下肢近端大血管断裂伤患者,估计术前出血量大于2 000 ml。患者经全麻气管插管后行健侧股动脉穿刺放置动脉球囊,调整球囊于腹主动脉末端,并充盈球囊暂时阻断腹主动脉血流以控制出血。结果15例患者中,经手术探查发现股静脉断裂9例,术中出血量为200~400 ml,平均304±102 ml,输血量400~600 ml,平均400±136 ml;股动脉断裂6例,术中出血量200~600 ml,平均355±134 ml,输血量800~1 200 ml,平均933±204 ml,手术过程顺利,术中患者生命体征平稳,术后15例患者血凝常规、血电解质和肾功能均在正常范围,术后3个月随访15例患者均未见缺血等相关并发症。结论低位腹主动脉球囊阻断技术操作简便,止血效果确切,具有重要临床应用价值。

Abstract:

Objective To evaluate the application of temporary balloon block on lower abdominal aorta during operation in patients with lower limb large vascular injury.Methods Fifteen patients with lower limb large vascular injury underwent emergency surgery and the preoperative blood loss was estimated above 2000ml.After general anesthesia,the puncture was performed through uninjured femoral artery and the balloon catheter was inserted.The position of balloon was adjusted to reach the end of abdominal aorta and 0.9% NS was filled to block the abdominal aorta temporarily.Results Among 15 patients,9 were diagnosed as femoral vein rupture with blood loss of 200ml to 400ml during operation,and blood transfusion of 400ml to 600ml;6 patients were diagnosed as femoral artery rupture with blood loss of 200ml to 600ml and blood transfusion of 800ml to 1200ml.There were no ischemic complications,the blood electrolyte,coagulation function and renal function were normal after operation in all patients.Conclusion Balloon block of lower abdominal aorta technique is simple,effective and can be used during operation for patients with large vessel injury in lower limbs.