经腹直肌外侧入路和髂腹股沟入路手术治疗骨盆髋臼骨折的临床效果  

Clinical Effect Between Lateral Rectus Abdominis Approach and Ilioinguinal Approach for the Treatment of Pelvic and Acetabular Fractures

作　　者：黄书杰 邓俊森 畅宁 马献忠 HUANG Shujie;DENG Junsen;CHANG Ning;MA Xianzhong(Henan Luoyang Orthopedic Hospital/Henan Orthopedic Hospital,Zhengzhou Hospital Area,Zhengzhou 450000,China)

机构地区：[1]河南省洛阳正骨医院/河南省骨科医院郑州院区,河南郑州450000

出　　处：《河南医学研究》2024年第1期65-69,共5页Henan Medical Research

摘　　要：目的对比分析经腹直肌外侧入路和髂腹股沟入路手术治疗骨盆髋臼骨折的临床应用效果。方法以随机化抽样法抽取2019年5月至2022年11月河南省洛阳正骨医院收治的86例骨盆髋臼骨折患者,按随机化分组法分为腹直肌外侧入路组(43例)和髂腹股沟入路组(43例)。腹直肌外侧入路组接受经腹直肌外侧入路手术,髂腹股沟入路组接受髂腹股沟入路手术。对比两组围手术期情况、骨折复位优良率、Harris髋关节功能评分量表(Harris)评分、并发症发生率、骨折复位满意度。结果腹直肌外侧入路组切口长度较髂腹股沟入路组短,术中出血量较髂腹股沟入路组少,手术时间较髂腹股沟入路组短(P<0.05)。腹直肌外侧入路组骨折复位优良率93.02%(40/43)较髂腹股沟入路组76.74%(33/43)高(P<0.05)。术后6个月,腹直肌外侧入路组疼痛、功能、畸形、活动度评分较髂腹股沟入路组高(P<0.05)。腹直肌外侧入路组并发症发生率[4.65%(2/43)]较髂腹股沟入路组[18.60%(8/43)]低(P<0.05)。腹直肌外侧入路组骨折复位满意度[95.35%(41/43)]较髂腹股沟入路组[81.40%(35/43)]高(P<0.05)。结论与髂腹股沟入路手术相比,经腹直肌外侧入路手术治疗骨盆髋臼骨折可减轻手术创伤,提高骨折复位优良率和满意度,并可提高髋关节功能,减少并发症。Objective To compare and analyze the clinical application value of surgical treatment of pelvic and acetabular fractures through the lateral rectus abdominis approach and the ilioinguinal approach.Methods A total of 86 patients with pelvic and acetabular fractures in Henan Luoyang Orthopedic Hospital from May 2019 to November 2022 were selected by random sampling method and divided into the lateral rectus abdominis approach group(43 cases)and the ilioinguinal approach group(43 cases).The lateral rectus abdominis approach group was operated through the lateral rectus abdominis approach,and the ilioinguinal approach group was operated through the ilioinguinal approach.The perioperative conditions,excellent and good rate of fracture reduction,Harris score,complication rate and fracture reduction satisfaction were compared between the two groups.Results Compared with the ilioinguinal approach group,the lateral rectus abdominis approach group had shorter incision length,less intraoperative blood loss,and shorter operation time(P<0.05).The excellent and good rate of fracture reduction in the lateral rectus abdominis approach group was 93.02%(40/43),which was higher than 76.74%(33/43)in the ilioinguinal approach group(P<0.05).At 6 months after operation,the scores of pain,function,deformity,and mobility in the lateral rectus abdominis approach group were higher than those in the ilioinguinal approach group(P<0.05).The incidence of complications was lower in the lateral rectus abdominis approach group(4.65%,2/43)than in the ilioinguinal approach group(18.60%,8/43)(P<0.05).The satisfaction rate of fracture reduction was higher in the lateral rectus abdominis approach group(95.35%,41/43)than in the ilioinguinal approach group(81.40%,35/43)(P<0.05).Conclusion Compared with the ilioinguinal approach,the lateral rectus abdominis approach in the treatment of pelvic and acetabular fractures can reduce surgical trauma,improve the excellent rate of fracture reduction and satisfaction,improve hip joint function,and reduce complica

关 键 词：骨盆髋臼骨折 经腹直肌外侧入路 髂腹股沟入路 

分 类 号：R683.3[医药卫生—骨科学]