改良Stoppa入路联合髂窝入路手术治疗不稳定骨盆前环骨折的疗效观察  

Effects of modified Stoppa approach combined with iliac fossa approach on unstable anterior pelvic ring fractures

作　　者：郭伟华[1] 王虎[1] 孙景福[1] 罗军[1] 刘晓雷[1] 吴仁涛 刘小鹏[1] 

机构地区：[1]东莞市厚街医院,广东东莞523960

出　　处：《中医临床研究》2018年第21期122-124,共3页Clinical Journal Of Chinese Medicine

基　　金：东莞市社会科技发展;项目编号:201650715001287

摘　　要：目的:探究改良Stoppa入路联合髂窝入路手术治疗不稳定骨盆前环骨折的疗效,并为这类特殊群体的优质诊疗照护积累循证经验。方法:选取我院于2014年9月-2016年8月收治的且符合纳入标准的38例不稳定骨盆前环骨折患者,在实施髂窝入路复位时,应妥善固定好骨盆后环,并采取改良Stoppa入路,切口一般是在耻骨联合上方2指处做一横切口,同时也可以采取正中纵切口,并切开皮肤及皮下脂肪,充分暴露腹膜外间隙,借助骨盆复位器械进行辅助复位,利用钢板进行固定塑形重建,待复位满意后再做最后的固定处理,对腹直肌前鞘要进行仔细修复,最后再缝合手术切口。结果:本组患者手术时间为80~150 min,平均时间为(116.7±5.9)min;术中出血量达200~700 m L,平均出血量达(400.8±13.5)m L。手术结束后,通常会选择X线片来确定双侧或单侧骨盆环复位情况,结果显示所有患者复位均满意。对所有患者实施为期7~10个月的随访,平均随访时间为(8.9±1.1)月,骨折愈合时间为8~13周,平均愈合时间为(12.8±2.3)周。除了仅1例发生左下肢深静脉血栓外,均未并发复位不良或切口感染、内固定失效、神经血管损伤等并发症。结论:对于不稳定骨盆前环骨折患者而言,采取改良Stoppa入路联合髂窝入路手术开展治疗,具有操作简便、暴露视野良好、损伤小的优点,能达到较为可观的临床疗效。Objective:To explore the effect of modified Stoppa approach combined with iliac fossa approach on unstable anterior pelvic ring fractures,and to accumulate evidence-based experience for the quality care of this special group.Methods:38 cases of unstable pelvic ring fractures patients treated in our hospital from September 2014 to August 2014 were selected,before the implementation of iliac fossa approach reset,the pelvic posterior ring was properly fixed by adopting modified Stoppa approach,the incision was usually 2 fingers to the above of the pubic symphysis with a crosscutting mouth,at the same time,the middle of longitudinal incision also can be adopted,and the skin and subcutaneous fat was cut to fully exposed the peritoneal clearance,with the aid of the pelvis auxiliary reset device,steel plate was used for fixing the shape reconstruction.After the restoration was satisfactory,the final fixation was done.The anterior sheath of the rectus abdominis was carefully repaired,and the incision was finally closed.Results:The operation time of patients in this group was 80~150min,and the mean time was(116.7±5.9)min.The intraoperative blood volume was 200~700ml,and the average amount of blood reached(400.8±13.5)ml.After the operation,the X-ray film was usually selected to determine the bilateral or unilateral pelvic ring reduction,and the results showed that all patients were satisfied with the reduction.All patients were followed up for a period of 7~10 months,and the mean follow-up time was(8.9±1.1)months.The fracture healing time was 8~13 weeks,and the mean healing time was(12.8±2.3)weeks.only 1 case suffered from deep venous thrombosis of the left lower limb,there were no complications such as poor reduction or incisional infection,internal fixation failure,neurovascular injury and other complications.Conclusion:For unstable pelvic ring fracture patients,modified Stoppa approach combined iliac fossa approach surgery treatment had the advantages of simple operation,exposed to good field of vision,small in dama

关 键 词：改良STOPPA入路 髂窝入路手术 不稳定骨盆前环骨折 

分 类 号：R683.3[医药卫生—骨科学]