588例骨盆骨折的流行病学特征与临床分析

Epidemiological characteristics and clinical analysis of 588 cases of pelvic fractures

目的探讨骨盆骨折的流行病学特征及临床特点,以提高对骨盆骨折的防治水平,进一步减少骨盆骨折的死亡率及伤残率。方法总结2007年11月～2009年5月收治的588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 588例患者中,男326例,女262例,男女比例为1.24:1,年龄为8～90岁。主要致伤原因为交通伤363例(61.7%)及高处坠落伤153例(26.0%)。AO/ASIF分型:61-A型340例(57.8%),61-B型95例(15.7%),61-C型33例(5.1%);62-A型54例(9.0%),62-B型38例(6.3%),62-C型14例(2.4%);61+62型14例(2.4%)。219例(37.2%)患者合并其它部位的损伤,其中腹部损伤、脑外伤、脊柱损伤等为骨盆骨折的常见合并伤。本组病例共发生休克31例,死亡8例,死亡率1.4%,抢救成功率74.2%。急诊行骨盆外固定支架固定31例,DSA25例,栓塞18例。二期行切开复位内固定术207例,术后恢复良好。结论骨盆骨折以男性中青年居多,绝大多数由高能量损伤所致,合并伤发生率较高,易发生休克。需要对高危人群加强安全教育和培训,从而有利于提高创伤救治水平和医疗质量,降低骨盆骨折的发生率,进一步减少伤残率和死亡率。

Objective To explore the epidemiological and clinical characteristics of pelvic fractures so as to improve the prevention and treatment, and reduce the rate of mortality and disability of the injured. Methods The clinical data of 588 patients with pelvic fractures from November 2007 to May 2009 were collected retrospectively. Their genders, ages, causes, associated injuries, prognoses were analyzed with SAS for windows 8.0e. Results The age range of the 326 male and 262 female patients was eight to 90 years. The injury was mainly caused by traffic accident in 363 cases （ 61.7% ） , and by falling from a height in 153 （26. 0% ） cases. According to AO/ASIF classification of pelvic fractures, 340 cases （57.8%） were 61-type A, 95 cases （15. 7% ） were 61-type B and 33 cases （5. 1% ） were 61-type C, while 54 cases （9. 0% ） were 62-type A, 38 cases （6. 3% ） were 62-type B and 14 cases （2.4%） were 62-type C. Both pelvic and acetabular fractures were found only in 14 cases, accounting for 2.4%. Among the 588 patients,219 cases （37.2%） suffered associated injuries which involved all over the body. The common associated traumas included abdominal injuries, craniocerebral traumas, spinal injuries et al. Shock occured in 31 patients. External fixation was performed in 31 cases and open reduction and internal fixation （ORIF） of pelvis was done for 207 cases. The total mortality was 1.4% （8/588）. Conclusions Pelvic fractures are mostly caused by high- energy injuries, often in young and middle-age males. The incidence of shock and associated trauma is high. Safety education needs to be enhanced and emergency trauma care training may be helpful in bringing down the incidence of pelvic fracture, and further reducing the mortality and invalidity.