关键词: 骨盆骨折, 硬膜外血肿, 救治方案

Abstract: Objective To explore the early treatment plan of massive arterial hemorrhage combined with extradural hematoma in patients with tile type C pelvic fracture,so as to provide reference for clinical early rescue.
Methods From January 2011 to January 2020,29 cases of shock coma with massive hemorrhage of artery and extradural hematoma (extradural hematoma >30ml,CT showed that the midline of brain deviated to the healthy side>5mm) were selected.According to different rescue methods,they were divided into control group and treatment group for retrospective analysis.The control group (n=14): the patients in the early stage were treated with routine rapid volume resuscitation and emergency operation room for pelvic fracture surgical intervention (abdominal packing,external fixation support,etc.).In the treatment group (n=15): patients in the early stage were treated with limited volume resuscitation + interventional room for iliac angiographic embolization.After the vital signs of the two groups were stable,they were immediately admitted to the operating room for craniotomy decompression and hematoma removal.
Results The volume of resuscitated fluid and the time of early treatment: the control group > the treatment group.The laboratory results of 4 hours after resuscitation: the hematocrit,HGB and platelet count of the control group were significantly lower than that of the treatment group,the concentration of blood lactate was significantly higher than that of the treatment group,and the time of prothrombin was longer than that of the treatment group.The rate of complications and mortality: the control group > the treatment group.
Conclusion limited volume resuscitation plus Interventional room angiographic embolization can reduce complications and improve the survival rate of patients with massive arterial hemorrhage and epidural hematoma.

Key words: pelvic fracture, epidural hematoma, treatment plan