两种不同入路重建钢板内固定治疗骨盆骨折的临床疗效及安全性对比分析

Comparative Analysis of Clinical Effect and Safety of Two Different Approaches of Reconstruction Plate Internal Fixation for Pelvic Fracture

目的:对比分析改良Stoppa入路与髂腹股沟入路重建钢板内固定治疗骨盆骨折的临床疗效及安全性.方法:选取2016年8月-2018年1月本科收治的80例骨盆骨折患者,采用随机数字表法分为对照组和观察组,每组各40例.对照组采用传统髂腹股沟入路重建钢板内固定治疗,观察组采用改良Stoppa入路重建钢板内固定治疗.对比两组患者的手术指标、并发症发生率、骨折复位Matta评分、骨盆功能Majeed评分.结果:观察组手术时间、术中出血量明显少于对照组,而切口长度明显短于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率5.00%明显低于对照组20.00%,两组比较差异有统计学意义(P<0.05);观察组骨折复位满意率(95.00%)和骨盆功能优良率(92.50%)高于对照组(87.50%、82.50%),但两组比较差异均无统计学意义(P>0.05).结论:改良Stoppa入路与髂腹股沟入路重建钢板内固定骨盆骨折的复位满意率及骨盆功能恢复情况相当,但改良Stoppa入路手术暴露充分、创伤小、解剖清晰,对血管神经组织损伤小,能有效缩小患者切口长度、缩短手术时间、减少出血量、降低并发症发生率,值得临床推广应用.

Objective:To comparatively analyze the efficacy and safety of modified Stoppa approach and ilioinguinal approach internal fixation for pelvic fracture.Method:A total of 80 patients with pelvic fracture admitted to our department were selected as the study object from August 2016 to January 2018.The patients were divided into control group and observation group with random number table method,40 cases in each group.The control group was treated with traditional ilioinguinal reconstruction plate and the observation group was treated with modified.Stoppa reconstruction plate.The operative indexes,complication rate,Matta score of fracture reduction and Majeed score of pelvic function were compared between the two groups.Result:The operative time and intraoperative hemorrhage in the observation group were less than those in the control group,and incision length was shorter than that in the control group(P<0.05).The incidence of complications in the observation group(5.00%)was significantly lower than that in the control group(20.00%)(P<0.05).The satisfactory rate of fracture reduction and excellent and good rate of pelvic function in the observation group was higher than those in the control group(95.00%vs 87.50%,92.50%vs 82.50%),the difference was not statistically significant(P>0.05).Conclusion:The satisfactory rate of reduction and the recovery of pelvic function of the modified Stoppa approach are similar to those of the ilioinguinal approach.However,the modified Stoppa approach has the advantages of sufficient exposure,small trauma,clear anatomy,small damage to the blood vessels and nerves,effective reduction of the incision length,operation time,bleeding volume and complication rate.It is worthy of clinical application.