Stoppa联合髂窝入路与髂腹股沟入路治疗髋臼方形区骨折的疗效比较  

Comparison of clinical effect of Stoppa approach combined with iliac fossa approach and ilioinguinal approach surgery in the treatment of acetabular quadrilateral area fractures

作　　者：侍朋举[1] 孙柏山[1] 张瑞杰[1] 王建生[1] 齐巍[1] 马爱国[1] 赵刚[1] SHI Peng-ju;SUN Bai-shan;ZHANG Rui-jie;WANG Jian-sheng;QI Wei;MA Ai-guo;ZHAO Gang(Department of Orthopaedics,The Second Hospital of Tangshan,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市第二医院创伤一科

出　　处：《创伤外科杂志》2019年第12期902-907,共6页Journal of Traumatic Surgery

摘　　要：目的比较Stoppa联合髂窝入路与髂腹股沟入路治疗髋臼方形区骨折的临床疗效。方法唐山市第二医院创伤一科2012年1月—2016年11月收治髋臼方形区骨折患者70例,男性48例,女性22例;年龄21~66岁,平均46.8岁。根据手术入路不同分为Stoppa联合髂窝入路组与髂腹股沟入路组,各35例,均行切开复位内固定术,比较分析两组患者的临床资料、手术显露时间、切口长度、术中出血量、术后住院时间、术后1周骨折复位质量、术后并发症发生情况及术后髋关节功能评分。结果Stoppa联合髂窝入路组和髂腹股沟入路组切口长度[(24.20±3.32)cm vs.(25.87±2.62)cm]、术后住院时间[(12.00±2.38)d vs.(12.69±2.41)d]、术后1周Matta影像学评分优良率(85.9%vs.82.8%)比较差异无统计学意义(P>0.05),两组患者手术显露时间[(22.60±3.20)min vs.(27.93±3.30)min]和术中出血量[(387.69±88.33)mL vs.(492.30±156.69)mL]比较差异有统计学意义(P<0.05)。术后两组患者髋关节功能评分随着恢复时间的延长均提高,但直至末次随访两组患者髋关节功能评分[(21.66±1.87)分vs.(20.77±1.56)分]比较差异无统计学意义(P>0.05)。虽然Stoppa联合髂窝入路组术后并发症发生率(20.0%)低于髂腹股沟入路组术后并发症发生率(31.4%),但差异无统计学意义(P>0.05)。结论对于髋臼方形区骨折,Stoppa联合髂窝组和髂腹股沟入路均效果显著。但Stoppa联合髂窝入路简便容易掌握,术中出血量少,可缩短手术时间,减少术后并发症,在处理髋臼方形区骨折中具有一定优势。Objective To compare and analyze the clinical effects of Stoppa approach combined with iliac fossa approach and ilioinguinal approach surgery in the treatment of acetabular quadrilateral area fractures.Methods Totally 70 patients with acetabular quadrilateral area fractures were admitted to the Second Hospital of Tangshan from Jan.2012 to Nov.2016.According to the different surgical approaches,they were divided into 35 cases of Stoppa approach combined with iliac fossa approach group and 35 cases of ilioinguinal approach group.The clinical data,surgical exposure time,incision length,intraoperative hemorrhage,postoperative hospitalization time,fracture reduction quality 1 week after operation,postoperative complications and postoperative hip function score were compared between the two groups.Results There was no significant difference between the Stoppa approach combined with iliac fossa approach group and the ilioinguinal approach group in the length of incision[(24.20±3.32)cm;(25.87±2.62)cm],postoperative hospitalization time[(12.00±2.38)d;(12.69±2.41)d]and the Matta imaging score 1 week after operation(85.9%,82.8%)(P>0.05).While the difference was statistically significant between the two groups in the exposure time[(22.60±3.20)min;(27.93±3.30)min]and intraoperative hemorrhage[(387.69±88.33)mL;(492.30±156.69mL)](P<0.05).The hip joint function score of both groups improved with the recovery time,but there was no significant difference between the two groups until the last follow-up(21.66±1.87,20.77±1.56,P﹥0.05).Although the incidence of postoperative complications(20%)in the Stoppa approach combined with iliac fossa approach group was lower than in the ilioinguinal group(31.4%),and the difference was not statistically significant(P>0.05).Conclusion For acetabular quadrilateral area fractures,the Stoppa approach combined with iliac fossa approach and the ilioinguinal approach have a significant effect.However,the Stoppa approach combined with iliac fossa approach has the advantages of easy to master,

关 键 词：髋臼骨折 方形区 入路 疗效 

分 类 号：R683.3[医药卫生—骨科学]