Research Progress Of Bleeding Of Pelvic Fracture

Pelvic fracture is a serious trauma with many complications. Injuries change quickly. Unstable pelvic ring injury often associated with severe bleeding, shock, and other important intra-abdominal pelvic organ injury. Hemorrhage leading to shock is one of the most serious and common complication of pelvic fractures,also the main reason for early death. Study of pelvic fracture hemorrhage pathogenesis and treatment, to reduce the pelvic fracture massive mortality of emergency patients has important significance.Severe traumatic bleeding with pelvic fractures, a lot of bleeding source, currently recognized that the main venous plexus bleeding, fractures stump bleeding, the other has around 10 ~ 15% of the well-known arterial bleeding. Pelvic venous plexus are rich and have no valves, abundant collateral circulation, not only to connect the inferior vena cava, but with the intraspinal venous system connected ,if they are bleeding, they accumulate in the retroperitoneal and difficult to stop. Tamponade is not effective to some coarse arterial bleeding, Followed the abnormal bleeding risks and extreme deterioration of the condition of patients.For the treatment of pelvic fractures with massive hemorrhage, at present there are still a lot of controversy: to some extent, the traditional linen packages and external fixation has its positive significance. The stability of the pelvis, the restoration of its volume, reduce bleeding. Many scholars study the current angiography embolization technique, and a lot of reports that the success rate is high. But the next questions are, vascular embolization only effective for some well-known artery. Some small and medium-sized arteries in patients with early shock often cramps, can not be superselective embolization, this one, and the second is the pelvic blood vessels has extensive collateral circulation, which to the superselective embolization will be difficult to bring. However, there were reports that theembolization of internal iliac artery and its branches may contribute to some complication such as gluteal muscle necrosis and sexual dysfunction. In contrast, the part of European scholars, they agreed to promote the treatment of pelvic packing, They consider arterial bleeding injury accounted for a smaller probability, and the operation requirements of high technology, which may delay the patient's condition changes. Some of them have carried out this two methods for comparison, consider that the pelvic packing is often more effective than pelvic angiography embolization. In the first time, to the pelvic fracture with massive hemorrhage patients, how to make an accurate assessment and the targeted therapy.In this paper, we will overview the bleeding of pelvic fracture from the aspects as follows: injury mechanisms and classification methods, anatomy and the source of bleeding, the patient assessment and first aid, treatment.