改良Stoppa入路和髂腹股沟入路治疗骨盆髋臼骨折疗效观察  

Efficacy of modified Stoppa approach and ilioinguinal approach in the treatment of pelvic acetabular fractures

作　　者：何立锋 贾力[1] 韦文军 HE Li-feng;JIA Li;WEI Wen-jun(Department of Orthopedics,Shangluo Central Hospital,Shangluo 726000,Shaanxi,CHINA;Department of Orthopedics,People's Hospital of Daliuta Experimental Area of Shenmu City,Shenmu 719315,Shaanxi,CHINA)

机构地区：[1]商洛市中心医院骨科,陕西商洛726000 [2]神木市大柳塔试验区人民医院骨科,陕西神木719315

出　　处：《海南医学》2023年第19期2780-2784,共5页Hainan Medical Journal

基　　金：陕西省自然科学基础研究计划项目(编号:2021JM—605)。

摘　　要：目的探究改良Stoppa入路和髂腹股沟入路治疗骨盆髋臼骨折的疗效及对患者围术期指标和术后并发症的影响。方法回顾性分析2018年1月至2022年1月商洛市中心医院收治的90例骨盆髋臼骨折患者的临床资料,按照手术入路不同分为观察组(采用改良Stoppa入路治疗)56例和对照组(采用髂腹股沟入路治疗)34例,比较两组患者治疗后的临床疗效、围术期指标、术后骨折复位质量,术前、术后1个月、术后2个月、术后3个月髋关节功能Postel评分以及术后并发症发生情况。结果治疗后,观察组患者的总有效率为98.21%,高于对照组的79.41%,差异有统计学意义(P<0.05);治疗后,观察组患者的手术时间、切口大小、出血量、术后住院时间分别为(1.05±0.11)h、(9.39±3.47)cm、(560.36±57.18)mL、(18.39±1.47)d,明显低于对照组的(1.34±0.53)h、(14.42±4.36)cm、(597.57±78.21)mL、(20.42±1.36)d,差异均具有统计学意义(P<0.05);治疗后,观察组患者的骨折复位优良率为92.86%,明显高于对照组的70.59%,差异有统计学意义(P<0.05);两组患者髋关节功能Postel评分组间、不同时间点及交互比较差异均有统计学意义(P<0.001),且观察组患者术后髋关节功能Postel评分明均显高于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者的总并发症发生率为5.36%,明显低于对照组的23.53%,差异有统计学意义(P<0.05)。结论与髂腹股沟入路比较,改良Stoppa入路治疗骨盆髋臼骨折能够提高骨盆髋臼骨折患者的临床疗效,改善其围术期指标,提高骨折复位质量,改善髋关节功能,降低术后并发症的发生风险。Objective To investigate the efficacy of modified Stoppa approach and ilioinguinal approach in the treatment of pelvic acetabular fractures and their influence on perioperative indicators and postoperative complications.Methods The clinical data of 90 patients with pelvic acetabular fractures admitted to Shangluo Central Hospital from January 2018 to January 2022 were retrospectively analyzed.According to different surgical approaches,they were divided into an observation group(treated with modified Stoppa approach,n=56),and a control group(treated with ilioinguinal approach,n=34).The clinical efficacy,perioperative indexes,postoperative fracture reduction quality,hip joint function Postel score before operation,1 month,2 months and 3 months after operation,and postoperative complications were compared between the two groups.Results After treatment,the total effective rate in the observation group was 98.21%,which was significantly higher than 79.41%in the control group(P<0.05).After treatment,the operation time,incision size,blood loss,and postoperative length of hospital stay in the observation group were(1.05±0.11)h,(9.39±3.47)cm,(560.36±57.18)mL,and(18.39±1.47)d,respectively,which were significantly lower than(1.34±0.53)h,(14.42±4.36)cm,(597.57±78.21)mL,(20.42±1.36)d in the control group(P<0.05).After treatment,the excellent rate of fracture reduction in the observation group was 92.86%,which was significantly higher than 70.59%in the control group(P<0.05).There were significant differences in hip joint function Postel score between groups,at different time points,and interaction between the two groups(P<0.001),while the postoperative hip function Postel score in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the total complication rate of observation group was 5.36%,which was significantly lower than 23.53%in the control group(P<0.05).Conclusion Compared with the ilioinguinal approach,the modified

关 键 词：改良STOPPA入路 髂腹股沟入路 骨盆髋臼骨折 临床疗效 术后骨折复位质量 髋关节功能 

分 类 号：R683.3[医药卫生—骨科学]