经腹直肌旁入路和髂腹股沟入路治疗复杂骨盆髋臼骨折的疗效比较
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摘要
目的 :探讨经腹直肌旁入路和髂腹股沟入路治疗复杂骨盆髋臼骨折的临床疗效。方法 :选取64例复杂骨盆髋臼骨折患者为研究对象,根据就诊顺序分为对照组和治疗组各32例。对照组行髂腹股沟入路,治疗组行腹直肌旁入路。随访6个月,比较两组患者的手术情况、髋关节功能恢复情况、复位满意度及并发症发生情况。结果 :治疗组髋关节功能优良率显著高于对照组(93.75%vs 78.13%,P <0.05),治疗组手术时间、术中出血量、切口长度及住院时间均显著少于对照组(P <0.05),治疗组并发症发生率及复位满意率与对照组比较无统计学差异(P> 0.05)。结论 :经腹直肌旁入路手术切口小、术中出血量少,患者术后恢复快,在改善患者髋关节功能方面较髂腹股沟入路手术更具优势。
Objective: To investigate the clinical effect of transrectus abdominis approach and ilioinguinal approach in the treatment of complex pelvic and acetabular fractures. Methods: Sixty-four patients with complex pelvic and acetabular fractures were selected as the study subjects. According to the order of their treatment, they were divided into a control group and a treatment group with 32 cases each. The control group underwent ilioinguinal approach while the treatment group underwent pararectus approach. The operation condition, hip function recovery, reduction satisfaction and complications were compared between the two groups after the patients were followed up for 6 months. Results: The excellent and good rate of hip function in the treatment group was significantly higher than that in the control group(93.75% vs 78.13%, P<0.05). The operation time, intraoperative bleeding volume, incision length and hospitalization time in the treatment group were significantly less than those in the control group(P<0.05). There were no significant differences in the incidence of complications and satisfaction rate of reduction between the two groups(P>0.05). Conclusion: Pararectus abdominis approach has smaller incision, less bleeding and faster recovery and more advantages in the improvement of hip function compared with ilioinguinal approach.
Objective: To investigate the clinical effect of transrectus abdominis approach and ilioinguinal approach in the treatment of complex pelvic and acetabular fractures. Methods: Sixty-four patients with complex pelvic and acetabular fractures were selected as the study subjects. According to the order of their treatment, they were divided into a control group and a treatment group with 32 cases each. The control group underwent ilioinguinal approach while the treatment group underwent pararectus approach. The operation condition, hip function recovery, reduction satisfaction and complications were compared between the two groups after the patients were followed up for 6 months. Results: The excellent and good rate of hip function in the treatment group was significantly higher than that in the control group(93.75% vs 78.13%, P<0.05). The operation time, intraoperative bleeding volume, incision length and hospitalization time in the treatment group were significantly less than those in the control group(P<0.05). There were no significant differences in the incidence of complications and satisfaction rate of reduction between the two groups(P>0.05). Conclusion: Pararectus abdominis approach has smaller incision, less bleeding and faster recovery and more advantages in the improvement of hip function compared with ilioinguinal approach.
引文
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[9]王虎,张堃,魏星,等.髂腹股沟入路短支撑钢板固定髋臼后柱治疗复杂髋臼骨折[J].中华骨科杂志,2017,37(1):17-23.
[10]刘江涛,王永贵,段祎,等.单一髂腹股沟入路重建钢板固定前柱结合空心钉固定后柱治疗髋臼双柱骨折[J].中国骨与关节损伤杂志,2016,32(12):1286-1287.
[2]李威,韩学明.经腹直肌旁入路治疗复杂骨盆髋臼骨折的临床疗效[J].中国社区医师,2017,33(23):53-54.
[3]麦奇光,谷诚,林学智,等.个性化金属三维打印髋臼翼形接骨板结合腹直肌外侧切口入路治疗复杂髋臼骨折[J].中华外科杂志,2017,55(3):172-178.
[4]钟华,陈劲,李建炜,等.腹直肌旁入路结合3D打印技术个性化手术治疗复杂骨盆髋臼骨折[J].中国骨与关节损伤杂志,2017,32(3):310-311.
[5]陈开放,段德胜,熊泽康,等.3D打印技术辅助高位髂腹股沟入路治疗复杂髋臼骨折[J].中华骨科杂志,2017,37(13):786-792.
[6]邓志刚,李凯.改良Stoppa入路联合髂嵴前入路与K-L入路治疗复杂髋臼骨折合并骨盆骨折的疗效比较[J].现代诊断与治疗,2017,28(2):290-291.
[7]李来峰,王辉,赵学春,等.改良Stoppa入路联合髂嵴前入路及K-L入路治疗复杂髋臼骨折合并骨盆骨折[J].中国矫形外科杂志,2015,23(18):1716-1719.
[8]倪明,沈燕国,胡晓亮,等.经改良Stoppa入路治疗骨盆髋臼骨折的临床体会[J].中国骨与关节损伤杂志,2013,28(2):101-103.
[9]王虎,张堃,魏星,等.髂腹股沟入路短支撑钢板固定髋臼后柱治疗复杂髋臼骨折[J].中华骨科杂志,2017,37(1):17-23.
[10]刘江涛,王永贵,段祎,等.单一髂腹股沟入路重建钢板固定前柱结合空心钉固定后柱治疗髋臼双柱骨折[J].中国骨与关节损伤杂志,2016,32(12):1286-1287.