经皮空心螺钉内固定与前路钢板内固定治疗不稳定性骨盆骨折的对比研究  

Comparison of percutaneous hollow screw osteosynthesis and anterior plate osteosynthesis for treatment of unstable pelvic fractures

作　　者：石成弟[1] 汤骏[1] 胡炜[1] 郭晓山[1] 

机构地区：[1]温州医科大学附属第二医院,浙江温州325027

出　　处：《中医正骨》2013年第6期10-13,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：浙江省温州市科技局项目(Y20110091)

摘　　要：目的:比较闭合复位经皮空心螺钉内固定及前路切开复位重建钢板内固定治疗不稳定性骨盆骨折的临床疗效及安全性。方法:回顾性分析接受手术治疗的59例不稳定性骨盆骨折患者的病历资料,采用闭合复位经皮空心螺钉内固定者31例(A组),采用前路切开复位重建钢板内固定者28例(B组)。记录并比较2组患者手术时间、术中出血量及住院时间,采用Matta骨盆骨折复位评定标准评定患者的骨盆骨折复位情况,采用Majeed骨盆骨折评价标准评定2组患者的临床综合疗效,同时记录并比较患者术后及随访期间的并发症发生情况。结果:①一般情况。A组患者手术时间[(45.60±12.50)min]、术中出血量[(25.80±5.60)mL]及住院时间[(8.60±3.40)d]均小于B组[(120.60±25.50)min,(580.50±210.20)mL,(19.30±5.20)d],差异均有统计学意义(t=14.582,P=0.000;t=14.701,P=0.000;t=9.422,P=0.000)。②骨折复位情况。A组优21例,良8例,可2例;B组优19例,良7例,可2例。2组患者骨折复位情况比较,差异无统计学意义(Z=-0.009,P=0.993)。③临床综合疗效。A组优24例,良5例,可2例;B组优22例,良5例,可1例。2组患者的临床综合疗效比较,差异无统计学意义(Z=-0.158,P=0.875)。④安全性。2组患者均未出现切口感染、医源性血管神经损伤及内固定失败等并发症。结论:经皮空心螺钉内固定和前路钢板内固定治疗不稳定性骨盆骨折的疗效及安全性相当,但前者具有手术时间短、术中出血少及术后恢复快的优势。Objective ： To compare the clinical curative effects and safety of closed reduction percutaneous hollow screw fixation and an- terior open reduction reconstruction plate fixation in the treatment of unstable pelvic fractures. Methods ：The medical records of 59 patients underwent operative treatment for their unstable pelvic fractures were analyzed retrospectively. Thirty-one patients （ group A） were adminis- trated with closed reduction and perentaneous hollow screw fixation, while 28 patients （ group B）were administrated with anterior open reduc- tion and reconstruction plate fixation. Such parameters as operation time, amounts of blood loss and hospitalization time were recorded and compared between the 2 groups ; and pelvic fractures reductions of patients were evaluated according to Matta evaluation standards of pelvic fractures reductions;also the general clinical curative effects of the 2 groups were evaluated according to Majeed evaluation standards of pel- vic fractures;meanwhile, the complications during postoperative and follow-up periods were recorded and compared between the 2 groups. Results ： The operation time （ （45.60±12.50 ） min） , amounts of blood loss （ （ 25.80 ±5.60 ） mL） and hospitalization time （ （ 8.60 ± 3.40 ） d） of group A were all lower than those of group B （ （ 120.60 ±25.50 ）rain, （580.50 ± 210.20 ）mL, （ 19.30 ±5.20 ） d）respectively, and there were statistical differences between the two groups （t = 14. 582, P = 0. 000;t = 14. 701 ,P = 0. 000;t = 9. 422,P = 0.000）. Twenty-one patients obtained an excellent result of fracture reduction ,8 good and 1 fair in group A;while 19 cases obtained an excellent result ,7 good and 2 fair in group B. There was no statistical difference in fi＇acture reduction between the 2 groups （ Z = - 0. 009, P = 0. 993 ）. Twenty-four patients obtained an excellent clinical curative effects ,5 good and 2 fair in group A;while 22 cases obtained an excellent clinical curative effects ,5 good and

关 键 词：骨盆 骨折固定术 内骨螺丝骨板治疗 临床研究性 

分 类 号：R687.3[医药卫生—骨科学]