耻骨联合分离程度与骶髂关节变化相关性研究

The experimental study of pubic diastasis and sacroiliac disruption

目的:探讨耻骨联合分离程度与骶髂关节变化之间的关系,通过耻骨联合的变化预测骶髂关节损伤程度。方法:防腐尸体骨盆8具,骨刀凿断耻骨联合,切断双侧骶棘,骶结节韧带和骶髂前韧带,制成开书型骨盆骨折,使耻骨联合分离至1、3、5、7cm时,用螺旋CT扫描,用标准CAD测量软件计算骶髂关节开大的距离。结果:耻骨联合分离1、3、5、7cm时,骶髂关节分离距离平均值分别为:左侧(6.93±0.44)、(9.63±0.21)、(11.64±0.33)、(14.35±0.29)mm,右侧(6.91±0.44)、(9.63±0.19)、(11.63±0.20)、(14.30±0.49)mm。耻骨联合分离3cm与5cm时,髓骼关节分离距有明显差异,P<0.05。耻骨联合分离与骶髂关节分离有相关性,r(左)=0.991,r(右)=0.992,P<0.01。回归方程:左骶髂关节分离距离(mm)=5.777+1.214×耻骨联合分离距离(cm),右骶髂关节分离距离(mm)=5.784+1.209×耻骨联合分离距离(cm)。结论:骶髂关节分离随耻骨联合的分离程度增加,根据耻骨联合分离距离可预测骶髂关节变化,指导临床治疗。

Objective：To investigate the relationship between diastasis of the symphysis pubis and changes of sacroiliac joints, to predict the standard of disruption of sacroiliac joints through the changes of public symphysis. Methods. The study was performed in 8 specimens of Chinese cadaveric pelvises. The pelvic viscera were removed and parietal pelvic fascia remained. Bilateral open-book pelvic injuries were created in cadaveric specimens by directly disrupting the public symphysis, bilateral anterior sacroiliac ligament, and sacrospinous and sacrotuberous ligaments. When the public diastasis was 1cm , 3cm, 5cm, 7cm respectively, Sacroiliac disruption was calculated using data acquired fi＇om pelvic computerized axial tomography （CT） by CAD measure software. Results： The sacroiliac disruption increased with the public diastasis increasing. When the public diastasis was 0cm, 1cm,3cm,5cm and 7cm respectively, the sacroiliac disruption was 6.93 ±0.44mm, 9.63 ±0.21mm, ll.64 ±0.33mm , 14.35 ±0.29mm on the left and 6.91 ±0.44mm, 9.63 ±0.19mm, 11.63 ±0.20mm, 14.30 ±0.49mm on the right respectively. Correlation between the change in pubic diastasis and the sacroiliac disruption were evaluated using linear regression analysis. R （left）=0.991, r （right） =0.992 , P〈0.01. The left sacroiliac disruption （mm）=5.777＋1.214 x pubic diastasis （cm）. The right sacroiliac disruption（mm）=5.784＋1.209x pubic diastasis（cm）. Conclusions： The sacroiliac disruption increased with the public diastasis increasing. The sacroiliac joints changes could be predicted though the distance of diastasis of public symphysis and provide instruction to clinical treatment.