不稳定性骨盆骨折老年患者的入路方案研究

Study on the approach program of elderly patients with unstable pelvic fractures

[目的]探讨不同的手术入路治疗不稳定性骨盆骨折的临床效果,为临床治疗不稳定性骨盆骨折提供依据。[方法]选择2010年1月-2013年12月在本院救治的不稳定性骨盆骨折老年患者59例作为研究对象,按照患者意愿分为观察组和对照组,观察组30例,应用改良Stoppa入路;对照组29例,应用髂腹股沟入路。比较两组患者的愈合情况、手术情况及康复功能。[结果]根据Matta评分标准,观察组优19例,良8例,中2例,差1例;对照组优18例,良8例,中2例,差1例,两组比较差异无统计学意义（P〉0.05）。在切口长度、手术时间、术中出血量、术后并发症、负重时间等方面比较,差异有统计学意义（P〈0.05）,观察组优于对照组;在骨折愈合时间、Majeed评分等方面比较,差异无统计学意义（P〉0.05）。[结论]经改良Stoppa入路治疗B型和C1型不稳定性骨盆骨折操作简单,创伤小,并发症少,恢复快,可获得良好的骨折复位及功能恢复。

[Objective]To discuss different surgical approaches for treatment of unstable pelvic fractures,provide the basis for clinical treatment of unstable pelvic fractures.[Method]Fifty-nine elderly patients with unstable pelvic fractures between January 2010 and December 2013 in our hospital treatment were selected as the research object,according to the wishes,patients were divided into observation group and control group.Thirty cases were in the observation group with application of modified Stoppa approach.Trventy-nihe cases were in the control group,with application of iliac inguinal approach.The healing operation conditions and function recovery were compared between groups.[Result]According to the Matta grading standard,in the observation group there were 19 excellent,8 good,2 fair,and 1 poorresdt.In the control group there were 18 excellent,8 good,2 fair,1 poor results,the two groups had no statistical significance（ P〈0.05）.In incision length,operative time,intraoperative blood loss,postoperative complications and weight-bearing time comparison,the differences were statistically significant（ P〈0.05）,the observation group was better than the control group.In fracture healing time and Majeed score,there were no statistically significant difference（ P〈0.05）.[Conclusion]The modified Stoppa approach to treat type B and type C1 unstable pelvic fractures has advantages of simple operation,small trauma,fewer complications,rapid recovery,and can obtain good fracture restore function.