骨盆内置固定架技术治疗骨盆骨折的疗效及影响因素分析  

Analysis of the curative effect and influencing factors of pelvic internal fixation technique in the treatment of pelvic fractures

作　　者：仝晓博[1] 郑永红[1] 罗耀超[1] Tong Xiaobo;Zheng Yonghong;Luo Yaochao(The Second Department of Orthopedics,Anyang Regional Hospital,Anyang,Henan 455000,China)

机构地区：[1]安阳地区医院骨二科,河南安阳455000

出　　处：《创伤外科杂志》2022年第6期458-463,共6页Journal of Traumatic Surgery

摘　　要：目的 探讨骨盆内置固定架技术治疗骨盆骨折的疗效及影响因素分析。方法 前瞻性分析2019年2月—2021年2月安阳地区医院骨二科收治骨盆骨折患者84例,男性45例,女性39例;年龄26~75岁,平均48.6岁;道路交通伤67例,高处坠落伤11例,挤压伤6例;患者均采用微创经皮髂前下棘骨盆内置固定架技术治疗,末次随访时采用Majeed功能评分评估患者临床疗效。术后随访6~8个月,平均随访5.0个月,根据临床疗效将患者分为疗效优良组(71例)、疗效不佳组(13例),采用单因素分析、多因素Logistic回归分析骨盆内置固定架技术治疗骨盆骨折疗效的影响因素。结果 末次随访时,Majeed功能评分优41例、良30例、可12例、差1例,优良率为85%。单因素分析结果显示,手术时机、Tile's分型、内固定前复位程度、骨折移位程度、术前神经损伤、合并髋臼骨折、术后并发症、术后规律康复治疗可能为骨盆内置固定架技术治疗骨盆骨折疗效的影响因素(χ2=6.826、6.233、4.451、9.629、4.233、4.377、4.008、5.418,均P<0.05),性别、年龄、体质量指数(BMI)、骨折原因、骨密度T值、术后负重时间等与骨盆内置固定架技术治疗骨盆骨折疗效无关(P>0.05)。多因素Logistic回归分析结果显示,手术时机≥2周(OR2.237,95%CI0.327~15.291)、Tile’s C型(OR8.447,95%CI0.961~74.206)、内固定前复位程度可、差(OR10.378,95%CI1.050~102.603)、骨折移位程度>4mm(OR11.776,95%CI1.434~96.707)、术后无规律康复治疗(OR4.742,95%CI0.622~36.176)为骨盆内置固定架技术治疗骨盆骨折疗效的独立危险因素(P<0.05),术前未合并神经损伤(OR0.100,95%CI0.011~0.904)、术后无并发症(OR0.101,95%CI0.013~0.786)为骨盆内置固定架技术治疗骨盆骨折疗效的独立保护因素(P<0.05),而术前合并髋臼骨折对骨盆内置固定架技术治疗骨盆骨折疗效无影响(P>0.05)。结论 骨盆内置固定架技术治疗骨盆骨折疗效确切,手术时�Objective To explore the curative effect and influencing factors of pelvic internal fixation technology in the treatment of pelvic fractures.Methods A prospective analysis was conducted in 84 patients with pelvic fractures admitted to the Second Department of Orthopedics in Anyang Regional Hospital from Feb.2019 to Feb.2021.There were 45 males and 39 females;their age ranged from 26 to 75 years,with an average of 48.6 years;there were 67 cases of road traffic injuries,11 cases of falling from high places and 6 cases of crush injury.All patients were treated with minimally invasive pelvic internal fixation technique through percutaneous anterior inferior iliac spine,and the Majeed functional score was used to evaluate the clinical efficacy of the patients at the last follow-up.The patients were followed up for 6 months after operation,with an average follow-up of 5.0 months.According to the clinical efficacy,the patients were divided into excellent curative effect group(71 cases)and poor curative effect group(13 cases).Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of pelvic internal fixation technology in the treatment of pelvic fractures.Results At the last follow-up,Majeed functional score showed excellent in 41 cases,good in 30 cases,fair in 12 cases,and poor in 1 case,with an excellent and good rate of 85%.The results of univariate analysis showed that the operation time,Tile’s classification,reduction degree before internal fixation,degree of fracture displacement,preoperative nerve injury,combined acetabular fracture,postoperative complications,and regular postoperative rehabilitation treatment may be factors affecting the curative effect of pelvic internal fixation technology in the treatment of pelvic fractures(χ2=6.826,6.233,4.451,9.629,4.233,4.377,4.008,5.418,all P<0.05),while gender,age,BMI,fracture reasons,bone mineral density T value and postoperative weight-bearing time were not related influencing factors(P>0.05).The results of multivariate

关 键 词：骨盆骨折 内置固定架 疗效 影响因素 

分 类 号：R683.3[医药卫生—骨科学]