改良Stoppa与经髂腹股沟入路用于髋臼骨折的临床观察  

Clinical observation of modified Stoppa and ilioinguinal approach for the acetabular fractures

作　　者：陈栋[1] 朱峰[2] 龚杰 耿德春[3] 王德超 CHEN Dong;ZHU Feng;GONG Jie;DI Dechun;WANG Dechao(Department of Orthopedics,Suzhou Xiangcheng People’s Hospital,Jiangsu Province,Suzhou 215000,China;Department of Joint Surgery,the First Affiliated Hospital of Suzhou University,Jiangsu Province,Suzhou 215000,China;Institute of Orthopedics,the First Affiliated Hospital of Suzhou University,Jiangsu Province,Suzhou 215000,China;the Fifth Department of Orthopedics,the Second Affiliated Hospital of Luohe Medical College,He’nan Province,Luohe 462300,China)

机构地区：[1]江苏省苏州市相城人民医院骨科,江苏苏州215000 [2]苏州大学附属第一医院关节外科,江苏苏州215000 [3]苏州大学附属第一医院骨科研究所,江苏苏州215000 [4]漯河医学高等专科学校附属第二医院骨五科,河南漯河462300

出　　处：《中国医药导报》2021年第3期84-87,92,共5页China Medical Herald

基　　金：河南省教育厅科学技术研究重点项目(16B320013)。

摘　　要：目的观察改良Stoppa与经髂腹股沟入路用于髋臼骨折的临床价值。方法选取2014年5月—2018年9月江苏省苏州相城人民医院收治的72例髋臼骨折患者为研究对象,采用随机数表法将其分为观察组和对照组,每组各36例。对照组采用髂腹股沟入路行骨折复位手术,观察组采用改良Stoppa入路行骨折复位手术。记录两组手术时间、术中出血量、切口长度、住院时间,采用Matta影像学评定标准及Matta功能评分标准分别对两组术后2个月骨折复位质量和髋关节功能进行评定,检测两组术前1d、术后1周血清中白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)水平,统计两组股外侧皮神经损伤、坐骨神经损伤、切口感染、创伤性关节炎发生情况。结果观察组手术时间、术中出血量、切口长度、住院时间均低于对照组,差异均有统计学意义(均P<0.05);两组复位满意率、髋关节功能优良率比较,差异无统计学意义(P>0.05)。两组术后血清中IL-6、CRP、PCT水平均较术前增高,差异均有统计学意义(均P<0.05),观察组术后血清中IL-6、CRP、PCT水平均低于对照组,差异均有统计学意义(均P<0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论改良Stoppa入路与髂腹沟入路对髋骨骨折患者手术疗效相当,但前者微创优势更为明显,能降低患者体内炎症反应风险,减少不良反应发生率,安全性更好。Objective To observe the clinical value of modified Stoppa and ilioinguinal approach in the treatment of acetabular fractures.Methods A total of 72 patients with acetabular fractures admitted to Suzhou Xiangcheng People’s Hospital,Jiangsu Province from May 2014 to September 2018 were selected as the study subjects,and they were divided into observation group and control group by random number table method,with 36 cases in each group.The control group was treated with ilioinguinal approach for fracture reduction,while the observation group was treated with modified Stoppa approach for fracture reduction.The operative time,intraoperative bleeding volume,incision length and hospitalization time were recorded.Matta imaging assessment criteria and Matta function score criteria were used to evaluate the reduction quality and hip function of the two groups at two months after operation,respectively.The levels of interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)in the serum of the two groups were measured one day before operation and one week after operation.The occurrence of lateral femoral cutaneous nerve injury,sciatic nerve injury,incision infection and traumatic arthritis were calculated.Results The operation time,intraoperative bleeding volume,incision length and hospitalization time in the observation group were lower than those in the control group,the differences were statistically significant(all P<0.05).There was no statistically significant difference between the two groups in satisfaction rate of reduction and excellent rate of hip joint function(P>0.05).The postoperative serum levels of IL-6,CRP and PCT in the two groups were all higher than those before surgery,and the differences were statistically significant(all P<0.05).The postoperative serum levels of IL-6,CRP and PCT in the observation group were all lower than those in the control group,and the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the observation group was lower than that in t

关 键 词：改良STOPPA入路 髂腹股沟入路 髋臼骨折 炎症因子 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]