髂骨瘀斑征在骨盆骨折合并腹部空腔脏器损伤中的诊断价值

Diagnostic value of iliac ecchymosis sign for abdominal organ injury combined with pelvic fracture

[目的]探讨髂骨瘀斑征在骨盆骨折合并腹部空腔脏器损伤中的相关性。[方法]2008年1月~2014年12月收治127例骨盆骨折合并腹部外伤患者,记录其年龄、性别、住院时间、卧床时间、创伤评分(AIS、ISS)、X线片检查、CT及强化CT检查、骨盆骨折分型及严重程度、内脏损伤严重程度、手术情况等相关数据,其中有髂骨瘀斑征患者18例(14.2%),与无髂骨瘀斑征患者进行对比分析。[结果]18例有髂骨瘀斑征患者手术探查证实合并腹部空腔脏器破裂患者17例(13.4%),符合率为94.4%。无骼骨瘀斑征组的患者ISS评分显著低于骼骨瘀斑征组(P<0.05);骼骨瘀斑征组患者住院时间、卧床时间明显长于无髂骨瘀斑征组患者(P<0.05)。[结论]髂骨瘀斑征可作为骨盆骨折合并腹部空腔脏器损伤的一项重要体征,对骨盆骨折合并腹部空腔脏器损伤的早期诊断具有重要的临床意义。

[Objective] To investigate the correlation of lilac ecchymosis sign to abdominal organ injury combined with pelvic fracture. [Method] From January 2008 to December 2014, 127 patients with pelvic fractures were admitted into our hospital. The patients＇age, gender, injury severity, X-ray, CT and enhanced CT examination, pelvic fracture type and se- verity, visceral injury severity, as well as the iliac ecchymosis sign records were recorded and analyzed. Of them, 18 patients had positive iliac eechymosis sign, whereas the remaining 109 ptatients proved negative. [Results] Of 18 patients who had ilium ecehymosis sign, 17 patients （94.4%） .Were verified rupture of hollow visera by surgical exploration, wherase. The ISS score in lilac ecchymosis syndrome group was significantly higher than that of without iliac ecchymosis syndrome group （P〈 0.05） . The hospitalization time, bed rest time of lilac ecchymosis syndrome group were significantly longer than those of with- out iliac ecchymosis syndrome group （P〈0.05） . [ Conclusion] The results revealed that, pelvic fracture with intestinal rup-ture does not necessarily have a bone bruising syndrome, but bone bruising syndrome is certainly related to intestinal rupture. Therefore, iliac ecchymosis sign in pelvic frac- tures has important clinical significance for diagnosis of ab- dominal hollow organ injury.