骶髂螺钉联合前柱螺钉治疗骨盆前后环损伤的应用研究  

Application of sacroiliac screws combined with anterior column screws to treatment of anterior-posterior pelvic ring injury

作　　者：张弛[1] 刘松[1] 梁笃 王钊[1] 王簕[1] ZHANG Chi LIU Song LIANG Du WANG Zhao WANG Le(the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Gnangdong 510150, China Guangzhou Orthopedic Hospital, Guangzhou, Guangdong 510045, China)

机构地区：[1]广州医科大学附属第三医院,广东省广州市510150 [2]广州市正骨医院,广东省广州市510045

出　　处：《微创医学》2017年第3期340-342,358,共4页Journal of Minimally Invasive Medicine

摘　　要：目的探讨骶髂螺钉联合前柱螺钉治疗骨盆前后环损伤的应用价值。方法 38例骨盆前后环损伤患者按随机抽签分为两组,每组19例。观察组行骶髂螺钉联合前柱螺钉固定治疗,对照组行骶髂螺钉联合外固定架治疗。比较两组患者术中出血量、手术时间、术后疼痛感、术后首次下地活动时间及Matts骨盆复位情况,记录术后并发症发生情况。结果观察组术中出血量、术后首次下地活动时间均显著少于对照组,手术时间显著长于对照组,差异均有统计学意义(P<0.05);观察组术后骨盆复位优良率高于对照组,并发症发生率低于对照组,但两组间比较,差异无统计学意义(P>0.05)。观察组术后2d和术后1周疼痛评分均显著低于对照组(P<0.05)。结论骶髂螺钉联合前柱螺钉用于骨盆前后环损伤疗效确切,能显著缩短患者康复进程,减少术后并发症,具有较高临床的应用价值。Objective To explore the application value of sacroiliac screws combined with anterior column screws in the treatment of anterior-posterior pelvic ring injury. Methods Thirty-eight patients with anterior-posterior pelvic ring injury were randomly divided into two groups by drawing lots, with 19 cases in each group. The observation group received fixation using sacroiliac screws combined with anterior column screw, and the control group was treated with sacroiliac screws combined with external fixator. The intraoperative blood loss, operative duration, postoperative pain, time of postoperative first ambulation and Marts pelvic reduction were compared between the two groups. The postoperative complications were recorded. Results Compared to the control group, the intraoperative blood loss and the time of postoperative first ambulation were less or shoIter, the operative duration was longer in the observation group （ P 〈 0.05 ）. The excellent rate of pelvic reduction was higher and the incident rate of complication was lower in the observation group compared to the control group, but there were no significant differences between the two groups （ P 〉 0.05 ）. The pain scores of the observation group were significantly lower than those of the control group after 2 day and 1 week of operation （P 〈 0.05）. Conclusion For the treatment of anterior-posterior pelvic ring injury, sacroiliac screws combined with anterior column screws can obtain a definite efficacy, can shorten the recovery process, reduce postoperative complications and is highly valuable for clinical application.

关 键 词：骨盆前后环 骶髂螺钉 前柱螺钉 微创 

分 类 号：R687.3[医药卫生—骨科学]