骨盆骨折合并骶丛神经损伤的手术治疗  

Surgical Treatment for the Lumbosacral Plexus Injury Associated with Pelvic Fractures

作　　者：彭扬国[1] 欧耀芬[1] 翁阳华[1] 王明新 朱思田 孙赞[1] 

机构地区：[1]广东省东莞市虎门医院骨科,523902 [2]东莞市南栅医院骨科

出　　处：《中国骨与关节损伤杂志》2006年第2期103-105,共3页Chinese Journal of Bone and Joint Injury

基　　金：东莞市科技局资助课题(编号:4401112001086K)

摘　　要：目的 探讨骨盆骨折合并腰骶丛神经损伤治疗的方法。方法回顾本组病例按Denis分类将骨盆骨折中骶骨骨折分为Ⅰ、Ⅱ、Ⅲ区，分析骨盆骨折合并腰骶丛神经损伤的临床特点及治疗效果。结果22例骨盆骨折合并腰骶丛神经损伤，随访6个月～5年。7例Ⅰ型骶骨骨折合并腰骶丛神经损伤，6例完全恢复正常，1例部分恢复；10例Ⅱ型骶骨骨折合并腰骶丛神经损伤，6例恢复正常，3例部分恢复，1例未恢复；5例Ⅲ型骶骨骨折合并腰骶丛神经损伤，2例恢复正常，2例部分恢复，1例未恢复。结论对于骨盆骨折并腰骶丛神经损伤的患者实施积极复位及内固定治疗，是非常重要的一环。有明显骨块压迫者，宜行神经探查松解术。Objective To investigate the methods for treatment of the lumbosacral plexus injury （LPI） associated with pelvic fractures. Methods A total of 22 patients with LPI were retrospectively reviewed. The sacrum fractures were divided into types Ⅰ ,Ⅱ and Ⅲ, as defined by Denis classification system and the clinical features and treatment effects for the lumbosacral plexus injury （LPI） associated with pelvic fractures were analyzed. Results The followed-up period ranged from 6 months to 5 years. In 7 patients with Type Ⅰ fracture, six patients were completely recovered and one patient was partially recovered. In 10 patients with Type 1] fracture, six patients were completely recovered, three patients were partially recovered and one patient was not recovered. In 5 patients with Type Ⅲ fracture, two patients were completely recovered, two patients were partially recovered and one patient was not recovered. Conclusion It is very important to perform the reduction and internal fixation for the patients with LPI associated with pelvic fractures actively. The nerve exploration and decompression should be performed only if there is compression of the bone blocks.

关 键 词：骨盆骨折 神经损伤 手术治疗 

分 类 号：R683.205[医药卫生—骨科学] R683.3[医药卫生—外科学]