不同体位及牵引力对股骨颈骨折后髋关节囊内压的影响  

Effects of Different Postures and Traction on the Pressure of Hip Joint Capsule after Femoral Neck Fracture

作　　者：赵辉[1] 王勇平[1] ZHAO Hui;WANG Yongping(Department of Orthopedics,the First Hospital of Lanzhou University,Lanzhou 730099,China)

机构地区：[1]兰州大学第一医院骨科,兰州730099

出　　处：《中国中医骨伤科杂志》2021年第2期45-48,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：甘肃省卫生行业科研计划项目(GSWSKY-2015-53)。

摘　　要：目的:分析不同体位及牵引力对股骨颈骨折后髋关节囊内压的影响。方法:选择2017年4月至2019年5月收治的160例股骨颈骨折患者为研究对象,通过测量患者髋关节囊内压,对比不同股骨颈骨折类型下,患者在不同牵引力及不同体位时所测得的髋关节囊内压。结果:160例患者中,最终124例(GardenⅠ型30例,GardenⅡ型50例,GardenⅢ型36例,GardenⅣ型8例)患者纳入结果分析;未纳入结果分析的36例患者中,30例患者在任何体位下髋关节囊内压无明显变化,6例患者在置入探头过程中出现压力骤增。124例患者中,不同体位下髋关节囊内压存在明显差异;外旋30°状态下髋关节囊内压明显低于其他体位,差异有统计学意义(P<0.05);内旋60°状态下囊内压明显高于其他体位,差异有统计学意义(P<0.05)。在不同体位下髋关节囊内压随骨折分型的递增而升高,差异有统计学意义(F=34.500,55.110,73.740,36.830,54.500,62.310,P<0.05)。髋关节囊内压随牵引力的增加而上升,差异有统计学意义(P<0.05);髋关节囊内压随骨折分型的递增而上升(F=39.400,51.020,46.360,14.450,P<0.05)。结论:髋关节囊内压升高是股骨颈骨折后常见的临床表现,体位与牵引力是影响囊内压的主要因素,当髋关节处于外旋状态下时囊内压最低,内旋状态下最高。囊内压随牵引力的增加而上升。Objective:To analyze the influence of different postures and traction on the internal pressure of hip joint capsule after femoral neck fracture.Methods:160 patients with femoral neck fractures were selected as the research objects from April 2017 to May 2019.By measuring the internal pressure of the hip joint capsule of the patients,the patients under different types of femoral neck fractures under different traction and different positions measured internal pressure of hip joint capsule.Results:160 patients in this group,the final 124(30 GardenⅠ,50 GardenⅡ,36 GardenⅢ,and 8 GardenⅣ)patients were included in the analysis of results.36 patients who were not included in the analysis of results,30 patients showed no significant changes in hip capsule pressure in any position,and 6 patients experienced a sudden increase in pressure during the probe placement.A comparative analysis of 124 patients included in the study results found that there were significant differences in the internal pressure of the hip joint capsule under different positions.The internal pressure of the hip joint capsule was significantly lower than other positions under external rotation of 30°(P<0.05),and the internal pressure of the capsule was significantly higher than other positions under internal rotation of 60°(P<0.05).In different positions,the hip capsule pressure increased with increasing fracture classification(F=34.500,55.110,73.740,36.830,54.500,62.310,P<0.05).Hip capsule pressure increased with increasing traction(P<0.05).Hip capsule pressure increased with increasing fracture classification(F=39.400,51.020,46.360,14.450,P<0.05).Conclusion:Increased internal pressure of the hip joint capsule is a common clinical manifestation after femoral neck fracture.Position and traction are the main factors that affect the internal pressure of the capsule.When the hip joint is in external rotation,the internal pressure is the lowest,and when the hip is in internal rotation highest.The pressure inside the sac increases as the traction

关 键 词：股骨颈骨折 髋关节囊内压 牵引力 不同体位 

分 类 号：R683.42[医药卫生—骨科学]