改良下腹正中切口内固定与外固定治疗骨盆前环骨折的对比研究  

Comparative study of modified lower abdominal median incision internal fixation and external fixation in the treatment of anterior pelvic ring fractures

作　　者：卢国良[1] 潘耀成 邹泽良[1] LU Guoliang;PAN Yaocheng;ZOU Zeliang(Ward 6,Department of Orthopedics,Foshan Hospital of TCM,Guangdong Province,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院骨六科

出　　处：《中国医药导报》2020年第3期74-77,共4页China Medical Herald

基　　金：广东省医学科学技术研究基金项目(B2018221)

摘　　要：目的比较改良下腹正中切口内固定与外固定治疗骨盆前环骨折的临床效果。方法回顾性分析2017年6月~2018年3月广东省佛山市中医院收治的骨盆前环骨折患者80例,按照不同手术方式,将其分为A组(n=36)和B组(n=44),A组给予骨盆外固定支架术治疗,B组给予经皮-钉棒系统固定术治疗。比较两组临床效果、手术时间、神经损伤发生率、术中出血量、切口长度、骨折愈合时间、视觉疼痛模拟评分(VAS)及并发症的发生情况。结果B组总有效率高于A组,差异有统计学意义(P<0.05)。两组术后1、3、6、12个月VAS评分呈逐渐下降趋势,且B组低于A组,差异均有统计学意义(均P<0.05)。B组手术时间、切口长度长于A组,术中出血量多于A组,骨折愈合时间短于A组差异均有统计学意义(均P<0.05)。两组神经损伤率比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论与骨盆外固定支架术比较,经皮-钉棒系统固定术虽然创伤较大,但骨折愈合时间短,神经损伤少,可有效减轻术后疼痛,提高临床效果,且不增加并发症发生率,临床应用价值较高。Objective To compare the clinical effect of modified lower abdominal median incision internal fixation and external fixation in the treatment of anterior pelvic ring fractures.Methods From June 2017 to March 2018,80 cases with anterior pelvic ring fractures who admitted to Guangdong Province,Foshan Hospital of TCM were retrospectively analyzed.According to the different surgical methods,they were divided into group A(n=36)and group B(n=44).Group A was treated with external pelvic fixation stent,group B was treated with percutaneous nail-rod system fixation.The clinical effect,operation time,incidence of nerve injury,intraoperative blood loss,incision length,fracture healing time,visual pain analogue score(VAS)and the occurrence of complications were compared betwee two groups.Results The total effective rate of group B was higher than that of group A,and the difference was statistically significant(P<0.05).VAS scores at 1,3,6 months and 12 months after surgery showed a gradually decreasing trend,and group B was lower than group A,with statistically significant differences(all P<0.05).The operative time and incision length of group B were longer than those of group A,intraoperative blood loss was higher than that of group A,and fracture healing time of group B was shorter than that of group A,the differences were statistically significant(all P<0.05).There was no significant differences in the rate of nerve injury(P>0.05).There were no significant differences in the incidence of complications between two groups(P>0.05).Conclusion Compared with external pelvic fixation stent,the percutaneous nail-rod system fixation has a relatively large wound,but the fracture healing time is shorter and the nerve injury is less,which can effectively reduce the postoperative pain,improve the clinical effect,and do not increase the incidence of complications and the clinical application value is higher.

关 键 词：改良下腹正中切口内固定 外固定 骨盆前环骨折 对比研究 

分 类 号：R687.3[医药卫生—骨科学]