经皮空心螺钉内固定与前路钢板内固定治疗老年不稳定骨盆骨折的疗效比较  

Clinical efficacy of percutaneous hollow screw internal fixation and anterior plate internal fixation in treatment of unstable pelvic fractures in the elderly

作　　者：梁永辉 顾锋[1] 郭文杰 刘宇[1] 李青松 刘申 韦兴 LIANG Yong-Hui;GU Feng;GUO Wen-Jie;LIU Yu;LI Qing-Song;LIU Shen;WEI Xing(Department of Orthopedics, Aerospace Center Hospital, Beijing 100049, China)

机构地区：[1]航天中心医院骨科,北京100049

出　　处：《中华老年多器官疾病杂志》2020年第4期317-320,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的对比经皮空心螺钉内固定与前路钢板内固定在治疗老年不稳定骨盆骨折中的疗效。方法回顾性分析2014年2月至2019年2月期间航天中心医院骨科收治的老年不稳定性骨盆骨折患者48例的临床资料,依据治疗方法分为2组:螺钉组(n=21)和钢板组(n=27)。对比2组患者围术期指标、术后12 h切口的视觉模拟量表(VAS)评分、并发症发生情况、出院时的骨折复位优良率和术后6个月的Majeed评分。采用SPSS 13.0软件进行统计分析。2组间比较采用t检验或χ2检验。结果2组患者基线资料间差异无统计学意义(P>0.05)。与钢板组相比,螺钉组患者的术中出血量[(35.7±5.7)和(467.3±210.4)ml]、手术耗时[(56.3±11.7)和(110.3±24.6)min]、术后12 h切口VAS评分[(2.81±0.79)和(5.44±1.17)]、住院时长[(8.5±2.9)和(18.6±5.1)d]和术后并发症发生率(4.8%和14.8%)均显著降低(P<0.05)。螺钉组和钢板组患者的骨折复位优良率(95.2%和88.9%)和术后6个月的Majeed评分[(88.2±5.9)和(85.1±6.3)]比较差异无统计学意义(P>0.05)。结论经皮空心螺钉内固定与前路钢板内固定在治疗老年不稳定性骨盆骨折中的疗效相当,但是经皮空心螺钉内固定更具微创优势,值得临床推广。Objective To compare the efficacy of percutaneous hollow screw internal fixation and anterior plate internal fixation in the treatment of unstable pelvic fracture in elderly patients.Methods Clinical data of 48 patients(aged from 60 to 72 years)with unstable pelvic fractures admitted in our department from February 2014 to February 2019 were collected and retrospectively analyzed.According to their surgical treatment,they were divided into screw group(n=21)and plate group(n=27).The perioperative indices,visual analogue scale(VAS)score of the incision in 12 h after operation,incidence of complications,excellent rate of fracture reduction at discharge and Majeed score in 6 months after operation were compared between the 2 groups.SPSS statistics 13.0 was used for statistical analysis.Student′s t test or Chi-square test was employed for the comparison between groups.Results There was no significant difference between the baseline data of the two groups.The screw group had significantly smaller intraoperative bleeding volume[(35.7±5.7)vs(467.3±210.4)ml],shorter operation time[(56.3±11.7)vs(110.3±24.6)min],lower VAS score of the incision in 12 h postoperatively[(2.81±0.79)vs(5.44±1.17)],shorter length of hospital stay[(8.5±2.9)vs(18.6±5.1)d],and less incidence of postoperative complications(4.8%vs 14.8%)when compared with the plate group(P<0.05).But there were no statistical differences in the excellent rate of fracture reduction at discharge(95.2%vs 88.9%)and Majeed score in 6 months after operation[(88.2±5.9)vs(85.1±6.3)]between the 2 groups(P>0.05).Conclusion In the treatment of unstable pelvic fracture in the elderly,percutaneous hollow screw internal fixation and anterior plate internal fixation have similar efficacy.But the former has the advantage of minimal invasion and is worthy of clinical promotion.

关 键 词：老年人 骨盆骨折 经皮空心螺钉内固定 前路钢板内固定 

分 类 号：R683.3[医药卫生—骨科学] R592[医药卫生—外科学]