骨盆骨折的临床流行病学分析

Clinic epidemiological analysis of pelvic fractures

目的探讨骨盆骨折的流行病学特点，以提高骨盆骨折的防治水平和救治质量，减少死亡率和伤残率。方法总结2001年6月～2006年11月收治的223例骨盆骨折患者的临床资料，统计分析患者性别、年龄、致伤原因及合并伤等情况。结果223例患者中，男137例，女86例，男女比例为1．59：1。年龄为3—93岁，20—39岁占57．4％。主要致伤原因：交通伤156例（70．0％），高处坠落伤48例（21.15％），重物砸伤11例（4．9％）。直接入院患者85例，转院患者138例。Tile分型：A型109例，B型53例，C型61例。89．7％的患者合并其它部位损伤，其中四肢长管状骨骨折、下腹部及会阴器官损伤、肋骨骨折及肺挫伤、颅脑伤及颅骨骨折、脊柱损伤等为骨盆骨折的常见合并伤。收住于近20个科室，发生休克26例，骨盆手术31例，死亡3例。结论骨盆骨折以男性青壮年居多；绝大多数由高能量创伤所致，合并伤发生率极高，易发生休克。加强创伤救洽培训和安全教育，进一步提高医疗质量，可减少骨盆骨折的伤残率和死亡率。

Objective To analyze the epidemiological characteristics of pelvic fractures in clinic so that prevention and treatment of the injury can benefit from the analysis. Methods The clinical data of the 223 patients with pelvic fractures from June 2001 to November 2006 were collected retrospectively. Their sex, age, cause, associated injury, prognosis were analyzed with SPSS for windows 11. O. Results The age range of the 137 male and 86 female patients was 3 to 93 years. The injury was caused by a road accident in 156 patients （70. 0% ）, by a fall from a height in 48 （21.5%）, and by a heavy crash in 11 patients. 85 patients were carried to our hospital directly while 138 patients were transferred from other hospitals. By Tile＇s classification of pelvic fractures, 48.9% of the cases were type A, 23.8% type B and 27.4% type C. Of the 223 patients, 89.7% suffered associated injuries which involved all over the body. The common associated traumas included long bone fracture at limbs, organ injury in the hypogastric zone and perineum, fracture of rib and pulmonary contusion, craniocerehral trauma and fracture of skull, spinal injury and skin destruction. The patients were admitted to almost 20 different departments including department of trauma orthopedic （51.1%） . Shock occurred in 26 patients. ORIF of pelvis was done for 31 patients. The total mortality was 1.3% （3/223）. Conclusions Pelvic fractures are mostly caused by high-energy injuries, often in young and middle-aged males. The incidence of shock and associated trauma to head, chest, abdomen, limb and spine is high. It is difficult for small hospitals to treat unstable fractures of pelvis. Emergency trauma care training and safety education may be helpful in reducing the mortality and invalidity. Close cooperation among different departments is considerably important.