Effect of arterial embolization combined with pelvic stabilization in early treatment of hemo-dynamically unstable pelvic fractures and influence on complications

Li Ming; Kang Lefei; Deng Zhen; He Kai; Deng Maolin

doi:10.3969/j.issn.1009-4237.2025.10.007

Abstract：Objective To explore the application effect of arterial embolization intervention combined with pelvic stabilization technique in the early treatment of hemodynamically unstable pelvic fractures and to assess the influence on the incidence of complications.Methods Clinical data of 103 patients with hemodynamically unstable pelvic fractures who were admitted to the Emergency Department,Changsha Traditional Chinese Medicine Hospital-from Mar.2021 to Mar.2024 were retrospectively selected.In the combined group,there were 51 cases that under-went arterial embolization intervention combined with pelvic stabilization;while in the control group,there were 52 cases that received pelvic stabilization alone.The HR,MAP,central venous pressure(CVP),shock index,recovery time of coagulation function,lactate clearance time,shock correction time,ICU treatment time,total length of hospital stay,operation time,success rate of hemostasis within 24 h after operation,dosage of norepinephrine,infusion volume of crystal fluid,blood transfusion volume(plasma infusion volume and concentrated red blood cell infusion volume),and complications were compared after treatment.Results After treatment in both groups,HR and shock index de-creased significantly,while MAP and CVP increased significantly(all P<0.05 compared with those before treat-ment).Moreover,the HR(beats/min)and shock index of the combined group were 105.9±7.2 and 0.76±0.25 respectively,whichweremuchlower than those of the control group(110.4±9.5 and 1.05±0.45);while the MAP(mmHg)and CVP(cmH2 O)were 79.6±10.0 and 5.3±1.5 respectively,which were much higher than those of the control group(71.1±9.3 and(4.4±1.3),all revealing significant differences between the two groups(P<0.05).Besides,the combined group showed much quicker recovery of coagulation function,lactic acid clear-ance,shock correction,as well as ICU and total hospital discharge,together with a much higher success rate of hemo-stasis within 24 h after surgery,but significantly longer operation time(all P<0.05).The dosage of norepinephrine and the input volume of crystal fluid,plasma and concentrated red blood cells in the combined group were all signifi-cantly less than those in the control group(all P<0.05).The incidence of disseminated intravascular coagulation,multiple organ failure and persistent hemorrhagic shock presented no statistically significant difference between the two groups(all P>0.05).The mortality rate,infection rate,acidosis rate,and anemia incidence rate of the com-bined group were 1.9%,3.9%,1.9%and5.8%respectively,which were all significantly lower than those of the control group(13.4%,17.3%,15.3%,23.0%,all P<0.05).Conclusion Compared with the simple perform-ance of pelvic stabilization,arterial embolization intervention combined with pelvic stabilization is more conducive to controlling bleeding,rapidly restoring hemodynamic stability and reducing mortality and complication rates.