切开内固定和外固定架联合应用治疗Tile C型骨盆骨折临床效果观察

Clinical effect of incision internal fixation combined with external fixation in treatment of C type Tile pelvic fracture

目的：研究切开内固定和外固定架联合应用治疗Tile C型骨盆骨折临床疗效。方法：选取100例Tile C型骨盆骨折患者，联合组、外固定组各33例，内固定组34例。联合组患者行切开内固定联合外固定架治疗，外固定组采用外固定架治疗，内固定组采用切开内固定法治疗。比较术前24小时各患者收缩压、舒张压、心率、空腹血糖、谷丙转氨酶、血肌酐等实验室指标，以及手术时间、术后Majeed评分、骨折愈合时间，另外术后2个月评价患者的康复效果，比较组间差异。结果：（1）术前24小时对患者实验室指标进行检查，可见2组患者收缩压、舒张压、心率、空腹血糖、谷丙转氨酶、血肌酐等水平基本都在正常范围内，组间比较无统计学差异，P＞0．05。（2）联合组手术时间明显长于外固定组和内固定组，出血量明显少于外固定组和内固定组，但术后Majeed评分更高，骨折愈合时间更短，差异显著，P＜0．05。（3）由表可知，联合组复位优秀者明显多于外固定组和内固定组，可、差者明显少于外固定组和内固定组，3组患者优良率分别为93．9％、69．7％、67．6％，联合组优良率远高于外固定组和内固定组，差异显著，F＝6．382，P＜0．05。（4）3组患者并发症发生率分别为12．1％、21．1％、18．2％，组间比较，联合组发生率低于后2组，但无明显差异，P＞0．05。结论：切开内固定和外固定架联合应用治疗Tile C型骨盆骨折疗效较好，对患者伤害小，并发症少，患者恢复较快。值得临床推广应用。

Objective： To investigate the clinical effect of open internal fixation combined with external fixator in the treatment of C type Tile pelvic fracture. Methods： 100 cases of C type Tile pelvic fracture were selected, combined group and external fixation group, 33 cases in each group and 34 cases in the internal fixation group. Patients in combination group were treated by incision in- ternal fixation combined with external fixation, external fixation group were treated with external fixation, internal fixation group was treated with open internal fixation. The laboratory indexes such as systolic blood pressure, diastolic blood pressure, heart rate, fast- ing blood glucose, alanine aminotransferase and serum creatinine were compared before the operation. The operation time, postoper- ative Majeed score, fracture healing time were compared between the three groups, and the rehabilitation effect of the patients was e- valuated after 2 months. The difference between the groups was compared. Results： （ 1 ） Systolic blood pressure, diastolic blood pressure, heart rate, fasting blood glucose, alanine aminotransferase, serum creatinine and other levels in the normal range, there was no statistical difference between the two groups, P 〉 0.05. （ 2 ） the operation time of the combined group was significantly lon- ger than that of the external fixation group and the internal fixation group, but the postoperative Majeed score was higher, the fracture healing time was shorter, and the difference was significant, P 〈 O. 05. （ 3 ） the excellent and good rates of the three groups were 93.9% , 69.7% and 67.6% , respectively. The excellent and good rate of the combined group was much higher than that of the ex- ternal fixation group and the internal fixation group, the difference was significant, P 〈 0.05. （ 4 ） The incidence of complications in the three groups were 12.1% , 21.1% , 18.2% , and the incidence rate of the combined group was lower than that in the latter two groups, but there was no significant difference, P 〉 0.05. Conclusion ： The combination of internal fixation and external fixation in the treatment of C type Tile pelvic fractures was better, with little harm and less complications to patients, and the patients recover quickly, which might be worthy of clinical popularization and application.