经皮空心螺钉固定用于不稳定骨盆骨折的效果观察

The application of percutaneous cannulated screw fixation in patients with unstable pelvic fractures

目的 探讨经皮空心螺钉固定治疗不稳定骨盆骨折的疗效.方法 98例不稳定性骨盆骨折患者按照数字表法随机分为两组,观察组49例,对照组49例,观察组采用经皮空心螺钉固定不稳定性骨盆骨折,对照组采用钢板内固定不稳定性骨盆骨折.观察两组手术时间、术中出血量、骨痂出现时间、骨折愈合时间、伤口长度及手术后优良率.结果 对照组优良率为89.8％,观察组优良率为98.0％,观察组优良率明显高于对照组（Х^2 =4.68,P＜0.05）.对照组手术时间、术中出血量、伤口长度分别为（121.6±26.4） min、（416.3±39.2）mL、（134.5±21.3）cm,观察组手术时间、术中出血量、伤口长度分别为（81.3±19.2） min、（63.5±12.8）mL、（15.8±2.1）cm,观察组手术时间、术中出血量、伤口长度均明显优于对照组（t=2.961、6.312、8.061,P＜0.05,P＜0.01）.对照组的骨痂愈合时间和骨折愈合时间分别为（14.2±2.7）周和（10.1±2.9）周,观察组的骨痂愈合时间和骨折愈合时间分别为（9.1±1.4）周和（6.5±1.5）周.观察组骨痂出现时间、骨折愈合时间均短于对照组（t=3.061、2.772,P＜0.05）.对照组术后有10例患者发生并发症,发生率为20.4％;观察组有3例发生并发症,发生率为6.1％;观察组并发症发生率明显低于对照组（Х^2 =6.14,P＜0.05）.结论 经皮空心螺钉固定治疗不稳定骨盆骨折疗效显著,并且并发症少.

Objective To study the application of percutaneous cannulated screw fixation in patients with unstable pelvic fractures.Methods According to the digital table,98 patients were randomly divided into the two groups,the control group were operated through plate fixation,and the observation group were operated through percutaneous cannulated screw fixation.Results After the surgery,the excellent rates were 89.8% in the control group and 98.0% in the observation group,which was significantly higher than that of the control group （Х^2 =4.68,P 〈 0.05）.The operative time,blood loss,wound length were （121.6 ± 26.4） min,（416.3 ± 39.2） mL,（134.5 ± 21.3） cm in the control group and （81.3 ± 19.2）min,（63.5 ± 12.8）mL,（15.8 ± 2.1）cm in the observation group.The operative time,blood loss,wound length were significantly lower than those of the control group （t =2.961,6.312,8.061,P 〈 0.05,P 〈 0.01）.Callus occurrence,fracture healing time were （14.2 ± 2.7） weeks,（10.1±2.9） weeks in the control group and （9.1 ± 1.4） weeks,（6.5 ± 1.5） weeks in the observation group.Callus occurrence,fracture healing time in the observation group were less than that of the control group （t =3.061,2.772,P 〈 0.05）.The control group had postoperative complications occurred in 10 patients,with an incidence of 20.4%,and the observation group had three cases of complications,the rate was 6.1%,the complications incidence of the observation group was significantly less than the control group （Х^2 =6.14,P 〈 0.05）.Conclusion Percutaneous cannulated screw fixation had significant effectiveness for patient with unstable pelvic fractures and fewer complications.