| 改良前入路髂腹股沟切口治疗骨盆及髋臼骨折的病例对照研究 |
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投稿时间：2013-09-06
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| 作者 | Author | 单位 | Address | E-Mail |
| 樊晓海 |
FAN Xiao-hai |
兰州军区兰州总医院全军骨科研究所, 甘肃 兰州 730050 |
Department of Orthopaedics, the General Hospital of Lanzhou Military Command, Lanzhou 730050, Gansu, China |
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| 时培晟 |
SHI Pei-sheng |
兰州军区兰州总医院全军骨科研究所, 甘肃 兰州 730050 |
Department of Orthopaedics, the General Hospital of Lanzhou Military Command, Lanzhou 730050, Gansu, China |
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| 薛云 |
XUE Yun |
兰州军区兰州总医院全军骨科研究所, 甘肃 兰州 730050 |
Department of Orthopaedics, the General Hospital of Lanzhou Military Command, Lanzhou 730050, Gansu, China |
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| 周顺刚 |
ZHOU Shun-gang |
兰州军区兰州总医院全军骨科研究所, 甘肃 兰州 730050 |
Department of Orthopaedics, the General Hospital of Lanzhou Military Command, Lanzhou 730050, Gansu, China |
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| 邓晓文 |
DENG Xiao-wen |
兰州军区兰州总医院全军骨科研究所, 甘肃 兰州 730050 |
Department of Orthopaedics, the General Hospital of Lanzhou Military Command, Lanzhou 730050, Gansu, China |
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| 李旭升 |
LI Xu-sheng |
兰州军区兰州总医院全军骨科研究所, 甘肃 兰州 730050 |
Department of Orthopaedics, the General Hospital of Lanzhou Military Command, Lanzhou 730050, Gansu, China |
lixush1968@sina.com |
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| 期刊信息：《中国骨伤》2014年，第27卷，第4期，第335-340页 |
| DOI：10.3969/j.issn.1003-0034.2014.04.017 |
| 基金项目:北京市科技计划首都临床特色应用研究项目（编号：Z111107058811062） |
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中文摘要:
目的：通过对63例骨盆及髋臼骨折患者手术前入路的治疗过程回顾性分析，获得改良髂腹股沟入路方法。
方法：自2006年1月至2013年1月应用髂腹股沟前入路手术治疗骨盆、髋臼骨折63例，男45例，女18例；年龄12～68岁，平均（37.71±13.41）岁。分别选用标准前入路和改良前入路手术处理，标准前入路（A组）手术处理37例，男26例，女11例，年龄（38.49±13.64）岁；改良前入路（B组）手术治疗26例，男19例，女7例，年龄（36.62±13.29）岁。观察比较两组手术切口（从切皮至完成髂腹股沟前方3个“窗口”）暴露时间、其间失血量、切口关闭时间，并采用Majeed功能评分比较两组治疗效果。
结果：两组比较，B组手术从切皮至完成髂腹股沟前方3个“窗口”暴露时间较短（P=0.006），失血量（暴露过程中出血）较少（P=0.002），关闭髂腹股沟切口时间短（P=0.002），而两组治疗效果差异无统计学意义。术后全组获得随访，时间3～36个月，平均（18.6±9.2）个月。术后随访期间未发现内固定松动及螺钉钢板断裂。骨折复位情况根据Matta标准评定：A组优28例，良8例，可1例；B组优20例，良5例，可1例。髋关节功能根据Majeed评分标准，A组优20例，良12例，中4例，差1例，平均（82.51±9.72）分；B组优13例，良10例，中3例，差0例，平均分（80.54±10.79）分。
结论：改良入路能提供良好的术野暴露范围，不易损伤到腹股沟韧带下方股神经及股动静脉，无须切开腹股沟管，可以避免出现腹股沟疝的发生，也减少了手术步骤，缩短了操作时间。 |
| 【关键词】骨盆 髋臼 骨折 病例对照研究 |
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| Case-control study on the modified ilioinguinal incision of anterior approach for the treatment of pelvic and acetabular fractures |
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ABSTRACT
Objective: To study modified ilioinguinal approach through the retrospective analysis on the surgical treatment of 63 patients with pelvic and acetabular fractures through anterior approach.
Methods: From January 2006 to January 2013,63 patients with pelvic and acetabular fractures were treated with the ilioinguinal anterior approach,including 45 males and 18 females,ranging in age from 12 to 68 years old,with an average of (37.71±13.41) years old. All the patients were divided into two groups:standard ilioinguinal anterior approach group(group A) and modified ilioinguinal anterior approach group(group B). In group A,there were 26 males and 11 females,with an average age of (38.49±13.64) years old. In group B,there were 19 males and 7 females,with an average age of (36.62±13.29) years old. Intraoperative and postoperative indicators in group A and B were observed and compared,including operation incision exposure time(from skin incision to complete the ilioinguinal in front of three ""windows""),the blood loss,incision close time and treatment effect of Majeed function score.
Results: Compared to group A,the incision exposure time of patients in group B was shorter,the blood loss (bleeding during exposure process) was less,and the close incision time was shorter,but the treatment effect of Majeed function score had no significant differences between two groups. All the patients were followed up,and the during ranged from 3 to 36 months,with an average of (18.6 ± 9.2) months. According to Matta standard assessment reduction of pelvic and acetabular fracture,there were 28 patients got an excellent result,8 good,and 1 fair in the group A;and 20 patients got an excellent result,5 good,and 1 fair in the group B. According to Majeed function score for hip function,20 patients got a satisfactory result,12 good,4 fair and 1 poor in group A,and the mean score was 82.51±9.72;and 13 patients got an satisfactory result,10 good,3 fair and 0 poor in group B,and the mean score was 80.54±10.79.
Conclusion: The modified approach has several advantages as follows:providing a good surgical exposure;preventing from the injury of femoral nerve,femoral artery and vein under the inguinal ligament; not needing to open the inguinal canal,which can avoid the occurrence of inguinal hernia,reduce operation prodedures and shorten operation time. |
| KEY WORDS Pelvis Acetabulum Fractures Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 樊晓海,时培晟,薛云,周顺刚,邓晓文,李旭升.改良前入路髂腹股沟切口治疗骨盆及髋臼骨折的病例对照研究[J].中国骨伤,2014,27(4):335~340 |
| 英文格式: | FAN Xiao-hai,SHI Pei-sheng,XUE Yun,ZHOU Shun-gang,DENG Xiao-wen,LI Xu-sheng.Case-control study on the modified ilioinguinal incision of anterior approach for the treatment of pelvic and acetabular fractures[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(4):335~340 |
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