腹直肌外侧入路与改良Stoppa入路内固定术治疗髋臼骨折患者的效果比较  

Comparison of effects of lateral rectus abdominis approach and modified Stoppa approach internal fixation in treatment of acetabular fractures

作　　者：葛伟 GE Wei(Emergency Trauma Surgery of Xincai County People’s Hospital,Zhumadian 463500 Henan,China)

机构地区：[1]新蔡县人民医院急诊创伤外科,河南驻马店463500

出　　处：《中国民康医学》2024年第17期147-150,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较腹直肌外侧入路与改良Stoppa入路内固定术治疗髋臼骨折患者的效果。方法:回顾性分析2021年3月至2023年2月该院收治的94例髋臼骨折患者的临床资料,根据手术入路不同将其分为观察组与对照组各47例。两组均行切开复位锁定钢板内固定术治疗,对照组采用改良Stoppa入路,观察组采用腹直肌外侧入路。比较两组复位效果、围术期指标、术后髋关节功能(改良Merle D’Aubigné-Postel评分)、手术前后应激反应指标[降钙素原(PCT)、皮质醇(Cor)、白细胞介素-6(IL-6)]水平,以及术后并发症发生率。结果:术后3个月,观察组复位优良率为91.49%(43/47),对照组复位优良率为87.23%(41/47),组间比较差异无统计学意义(P>0.05);两组术中骨折显露时间比较,差异无统计学意义(P>0.05);观察组术中出血量少于对照组,手术时间、住院时间及骨折愈合时间均短于对照组,差异有统计学意义(P<0.05);术后3个月,观察组疼痛、行走功能、活动范围等改良Merle D’Aubigné-Postel评分均低于对照组,差异有统计学意义(P<0.05);术后1 d,两组血清PCT、Cor、IL-6水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为4.26%(2/47),低于对照组的19.15%(9/47),差异有统计学意义(P<0.05)。结论:改良Stoppa入路与腹直肌外侧入路内固定术对髋臼骨折患者的复位效果相当,但腹直肌外侧入路可减少术中出血量,缩短手术时间、住院时间和骨折愈合时间,减轻术后应激反应,降低并发症发生率,提高髋关节功能。Objective:To compare effects of lateral rectus abdominis approach and modified Stoppa approach internal fixation in treatment of acetabular fractures.Methods:The clinical data of 94 patients with acetabular fractures admitted to this hospital from March 2021 to February 2023 were retrospectively analyzed.According to the different surgical approaches,they were divided into observation group and control group,47 cases in each group.Both groups were treated with open reduction and locking plate internal fixation.The control group was treated with modified Stoppa approach,while the observation group was treated with lateral rectus abdominis approach.The reduction effect,the perioperative index levels,the postoperative hip joint function(modified Merle D’Aubigné-Postel score),the stress response indexes[procalcitonin(PCT),cortisol(Cor),interleukin-6(IL-6)]levels before and after the surgery,and the incidence of postoperative complications were compared between the two groups.Results:Three months after the surgery,the excellent and good rate of reduction in the observation group was 91.49%(43/47),and that in the control group was 87.23%(41/47),there was no significant difference between the two groups(P>0.05).There was no significant difference in the fracture exposure time between the two groups(P>0.05).The intraoperative blood loss in the observation group was less than that in the control group;the operation time,the hospitalization time and the fracture healing time were shorter than those in the control group;and the differences were statistically significant(P<0.05).Three months after the surgery,the modified Merle D’Aubigné-Postel scores of pain,walking function and range of motion in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).One day after the surgery,the levels of serum PCT,Cor and IL-6 in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,a

关 键 词：腹直肌外侧入路 改良STOPPA入路 髋臼骨折 锁定加压钢板 内固定术 

分 类 号：R687.3[医药卫生—骨科学]