腹直肌外侧直切口手术入路治疗同侧不稳定型骨盆骨折的疗效分析

Clinical Application of the Lateral Edge of the Rectus Abdominis Incision for Treatment of Ipsilateral Unstable Pelvic Fracture

目的研究腹直肌外侧切口入路及传统髂腹股沟入路治疗同侧不稳定型骨盆骨折的临床效果。方法随机选取2014年7月-2018年1月该院收治的同侧不稳定型骨盆骨折患者72例,随机分为观察组和对照组,各36例。观察组采用腹直肌外侧切口入路,对照组采用传统髂腹股沟入路。比较两组患者的手术持续时间、术中出血量、愈合时间及术后6个月髋关节运动功能评级的差异。结果观察组平均手术时间(90.25±16.28)min,对照组平均手术时间(153.74±11.29)min,差异有统计学意义(t=1.559,P=0.001);观察组平均术中出血量(627.3±158.27)mL,对照组平均术中出血量(985.6±156.67)mL,差异有统计学意义(t=4.267,P=0.001);观察组平均骨折愈合时间(6.27±0.97)周,对照组平均骨折愈合时间(9.97±1.37)周,差异有统计学意义(t=1.009,P=0.001);观察组手术有效率95.83%,对照组手术有效率75.00%,差异有统计学意义(χ^2=10.34,P=0.032)。结论采用腹直肌外侧切口入路治疗同侧不稳定型骨盆骨折优势明显,具有临床推广价值。

Objective To study the clinical effect of lateral rectus abdominis approach and traditional ilioinguinal approach in the treatment of ipsilateral unstable pelvic fractures. Methods A total of 72 patients with ipsilateral unstable pelvic fractures treated from June 2014 to January 2018 were randomly divided into observation group and control group, with 36 cases each. The observation group was treated with the lateral incision of rectus abdominis and the control group with the traditional ilioinguinal approach. The operative duration, intraoperative bleeding, healing time and hip motor function rating were compared between the two groups. Results The average operation time of the observation group was(90.25±16.28)min, and the average operation time of the control group was(153.74±11.29)min. The difference was statistically significant(t=1.559,P<0.001). The average intraoperative bleeding volume in the observation group was(627.3±158.27)mL, and that was(985.6±156.67)mL in the control group. The difference was statistically significant(t=4.267, P<0.001). The average healing time of fracture was(6.27±0.97)weeks in the observation group, and that was(9.97±1.37)weeks in the control group. The difference was statistically significant(t=1.009, P=0.001). The effective rate of operation was 95.83% in the observation group, and that was 75.00% in the control group. The difference was statistically significant(χ^2=10.34, P =0.032). Conclusion The treatment of ipsilateral unstable pelvic fracture by lateral incision of rectus abdominis is superior. And it has clinical promotion value.