不同方法治疗不稳定骨盆损伤的结果比较

OutcomeComparisoninDiferentTreatmentsofUnstablePelvicInjuries

目的：对比研究非手术治疗、延期手术及早期手术固定不稳定骨盆损伤的治疗结果．方法：选择１９８６～１９９４年全身伤情相当的不稳定骨盆损伤患者４４例，按非手术治疗、早期（３天内）及晚期（３天后）手术固定分为三个组，观察治疗结果．结果：手术患者的疗效好于非手术患者，早期手术效果好于延期手术，其中住院天数、部分负重时间、３个月完全负重人数、需进康复中心人数具有统计学差异．在治疗过程中观察到，伤后３天后复位骨盆损伤的困难明显增加，而１周后则很难达到准确复位．结论：不稳定骨盆损伤应采取早期手术治疗，对早期血压不稳定的骨盆损伤患者行外固定应作为抢救工作的一部分．

Aim:Tocomparetheresultsofconservative,delayedandearlyoperativetreatmentsinunstablepelvicinjuries.Methods:Forty-fourpatientswithunstablepelvicinjuriesandequivalentassociatedinjurieswereselectedfrom1986to1994.Toevaluatetheresults,thepatientsweredividedintoconservative,delayedandearlyoperativetreatmentgroups.Results:Theresultsshowedthatoperativetreatmentoftheunstablepelvicinjuriescouldhavebetteroutcomethancomservativetreatment,andthatearlyoperativefixationcouldresultinbeteroutcomethandelayedfixation.Oftheobservingparameters,thedurationofhospitalstay,partialloadingtimeandthenumberoffulloadingpateints3monthsaftertheinjuryweresignificantlydifferentbetweenthe3groups.Weobservedclinicalythatwhenfracturefixationwasdelayedformorethan3days,thereductiondifficultyincreasedobviouslyandifthefixationwasdelayedformorethanaweek,precisereductionwasalmostimpossable.Conclusion:Unstablepelvicinjuriesshouldbetreatedoperativelyandearly,andpelvicexternalfixationforhemodynamicalyunstablepatientsshouldbeapartofprimaryresuscitation.