自体髂骨供骨区的并发症及防治

Prevention and treatment of complications in the donor site of iliac bone autograft

目的总结分析髂骨供骨区并发症产生的原因及机制,探索其防治策略。方法回顾性分析598例实施髂骨供骨手术患者临床资料,分析髂骨供骨区并发症及相关因素。结果髂骨供骨区并发症115例,其中切口裂开5例,切口血肿17例,切口疼痛40例,皮神经损伤21例,切口感染10例,切口处持续渗出8例,髂棘骨折6例,切口疝、外观改变共8例。结论髂骨供骨区并发症的发生与取骨方式、术者操作及对解剖层次的熟悉程度密切相关,应引起临床医师的足够重视。

Objective To comment on the prevention and treatment of complications in the iliac crest donor site.Methods The medical records of 598 surgical patients who had undergone autotransplantation of iliac graft were reviewed to explore the donor site morbidity.Results Donor site complications were encountered in 115 of the 598 cases, i.e. 5 cases of wound disruption,17 incision hemotoma,40 incision pain,21 cutaneus nerve injury,10 wound infection,8 persistent exudation,6 iliac crest fracture,8 incisional hernia and local deformity.Conclusion The iliac donor site complications were closely related to the operating procedures, the manner of graft taking and the surgeon's anatomical knowledge, which all deserve emphasis to prevent the complications.