耻骨联合分离程度与骨盆容量变化相关性的实验研究△  

Experiental study of pubic diastasis and pelvic volume

作　　者：潘进社[1] 张英泽[1] 张奉琪[1] 李亚洲[1] 彭阿钦[1] 王珺琛[1] 

机构地区：[1]河北医科大学第三医院创伤急救中心,石家庄050051

出　　处：《中国矫形外科杂志》2006年第15期1176-1178,共3页Orthopedic Journal of China

基　　金：河北省卫生厅资金资助(No.1019)

摘　　要：[目的]探讨不稳定的骨盆骨折耻骨联合分离程度与骨盆容量变化之间的关系,预测骨盆出血量。[方法]防腐尸体骨盆8具;去除盆腔脏器,保留盆壁筋膜;骨刀凿断耻骨联合,切断双侧骶棘,骶结节韧带和骶髂前韧带,制成开放性骨盆骨折,使耻骨联合分离至1、3、5、7 cm时,用螺旋CT扫描,用标准CAD测量软件计算盆腔容量。[结果]在开放性骨盆骨折中随着耻骨联合分离距离加大,骨盆腔容量逐渐增大。耻骨联合完整时,盆腔容量平均值为(915±121)m l,耻骨联合分离1、3、5、7 cm时,盆腔容量平均值分别为(969±114)、(1 074±112)、(1 247±120)、(1 406±103)m l。其相关性r=0.77,P<0.01,其回归方程为:骨盆容量(m l)=918+50*耻骨联合分离距离(cm)。[结论]不稳定骨盆骨折时,随着耻骨联合的分离程度增加,骨盆容量明显增加,根据耻骨联合分离距离可预测骨盆内出血量,指导临床治疗。[ Objective] To discus the relationship between pubic symphysis disruption and pelvic volume with unstable pelvic fractures. [ Method] The pelvic viscera were removed and parietal pelvic fascia remained in 8 specimens of Chinese cadaveric pelvises. Bilateral open-book pelvic injuries were created in cadaveric specimens by directly disrupting the public symphysis, bilateral anterior sacroiliac ligament, and sacrospinous and sacrotuberous ligaments. When the public diastasis was 1, 3, 5, 7 cm, pelvic volume was calculated using data acquired from pelvic computerized axial tomography （CT） by CAD measure software. [ Result] The pelvic volume increased with the public diastasis increasing. When the public diastasis was 0, 1, 3, 5, 7cmrespectively, the pelvic volume was （969±114）, （1 022 ± 112）, （1 162±103）, （1 267±114） ml respectively. Correlation between the change in pubic diastasis and the percent age of increase volume realized in the true and false （ entire volume minus true volume） pelvis were evaluated using linear regression analysis, r = 0. 77, P 〈 0. 01, Pelvic volume （ml） =918 ±50^＊ pubic diastasis （cm） were demonstrated. [Conclusion] The pelvic volume increased with the public diastasis increasing when pelvic fractures were unstable. According to the public diastasis, the bleeding volume with unstable pelvic fractures can be predicted and treatment can be instructed.

关 键 词：骨盆骨折 耻骨联合 分离 骨盆容量 

分 类 号：R683.3[医药卫生—骨科学]