骨盆骨折术后并发症的预防  

Prevention of Postoperative Complications of Pelvic Fracture

作　　者：王愉思[1] 徐勇强[1] 魏磊平[1] 阎戈[1] 康亦峰[1] 黄焱[1] 陈润新[1] 何畔[1] 贾真[1] 冯嗣寅[1] 廖新华[1] 

机构地区：[1]湖南省人民医院暨湖南师范大学第一附属医院创伤骨科,湖南长沙410005

出　　处：《医学临床研究》2011年第9期1750-1752,共3页Journal of Clinical Research

摘　　要：[目的] 探讨骨盆骨折术后并发症的预防.[方法] 回顾性分析2005年2月至2009年12月本院收治的53例骨盆骨折病例资料.患者在伤后5～10 d内,按Tile分型,选择相应手术入路,用重建钢板固定,术后功能锻炼.应用Majeed功能评价标准进行功能评定,并对患者术后并发症情况回顾分析.[结果] 除1例死亡外,余52例均获5个月至4年随访,平均18个月.本组病例优、良级37例,中级9例,优良率为71%,6例患者出现术后并发症.其中1例患者出现伤口感染,2例髋臼骨折患者术后出现股骨头缺血性坏死、1例患者因骨折复位不良,出现跛行、疼痛.2例患者出现下肢深静脉血栓形成,经处理后好转.1例因合并高血压,冠心病及胃溃疡,最终应激性溃疡消化道大出血死亡.术后患者未出现严重异位骨化及创伤性关节炎.[结论] 重建钢板治疗骨盆骨折在早期抢救降低死亡率、减少并发症上有明显优势.但手术置钉较为复杂,需要有经验丰富的骨科医师精心治疗,多做临床解剖学研究,才能减少术后的并发症.[Objective] To explore the prevention of postoperative complications of pelvic fracture. [Methods] The clinical date of 53 patients with pelvic fracture in our hospital from Feb. 2005.2 to Dec. 2009 were analyzed retrospectively. According to Tile classification, the appropriate operation approach was selected for patients within 5-10 days after injury. And the patients were treated with pelvic reconstructed plate fixation. Functional exercise was performed after operation. Majeed standard was used for the function evaluation. Postoperative complications of patients were reviewed. [Results] Except on case died, other 52 patients were followed up for an average of 18 months（ranged form 5 to 48 months）. The 37 cases achieved excellent and good results and 9 cases achieved fair results, and the excellent and good rate was 71%. Postoperative complications occurred in 6 cases. Among the 6 cases, one ease had wound infection, and 2 cases with acetabulum fracture had avaseular necrosis of femoral head, and one case had lameness and pain caused by malreduction, and 2 cases had deep venous thrombosis of lower limbs and got better after treatment. One case complicated with hypertension, coronary heart disease and gastric ulcer died of stress ulcer and massive hemorrhage of gastrointestinal tract. No severe ectopic ossification or traumatic arthritis were found after operation. [Conclusion] The reconstructed plate fixation for the treatment of pelvic fracture has obvious advantages of reducing mortality and complications in early periods. However it is complicated to safely fix screw. Careful therapy by practiced orthopedist and many clinical anatomy researches can reduce postoperative complications.

关 键 词：骨盆骨/损伤 骨折/外科学 手术后并发症 

分 类 号：R683.3[医药卫生—骨科学]