经腹直肌旁入路和髂腹股沟入路治疗复杂骨盆髋臼骨折效果对比研究

Comparative study on the effect of transrectus parabdominis approach and ilioinguinal approach in the treatment of complex pelvic acetabular fractures

目的探讨经腹直肌旁入路和髂腹股沟入路治疗复杂骨盆髋臼骨折的效果。方法选取2016年1月至2021年6月该院收治的复杂骨盆髋臼骨折患者48例,按不同入路治疗方案分为研究组和对照组,每组24例。对照组经骼腹股沟入路治疗,研究组经腹直肌旁入路治疗。观察两组患者治疗后髋关节功能情况,对比两组患者术中出血量、手术及住院时间、切口长度、复位满意、并发症发生情况等。结果与对照组比较,研究组患者治疗后髋关节功能恢复情况更理想,手术及住院时间、切口长度更短,术中出血量更少于,复位满意率更高,并发症发生率更低,差异均有统计学意义(P<0.05)。结论与经骼腹股沟入路治疗方式比较,经腹直肌旁入路治疗复杂骨盆髋臼骨折患者效果更理想,一方面可优化患者髋关节功能骼腹股沟;复杂骨盆髋臼骨折;腹直肌旁;髋关节;入路治疗,显著减少患者住院和手术时间,节约患者手术花费;另一方面也可提升患者复位满意度,降低并发症发生率。

Objective To select patients with complex pelvic acetabular fractures to be included in the study,and give them two approaches respectively,namely,the parabdominis and iliac inguinal approaches,to observe the application value of the two approaches.Methods Atotalof 48 patients with complex pelvic acetabular fractures admitted to thishospital from January 2016 to June 2021 were collected.According to the different approaches,they were divided into two groups,with 24 patients in each group.The patients with iliac inguinal approach were taken as the control group.Patients with parabrectus approach were used as the study group to observe the hip function of the two groups after different approaches,and to compare the amount of intraoperative blood loss,operation,length of hospital stay and incision length of patients in the two groups during the approach treatment.Meanwhile,the satisfactory reduction and complications of the two groups were compared.Results Compared with the control group receiving the treatment with ilioinguinal approach,the functional recovery of hip joint in the study group was more ideal(P<0.05);At the same time,during the treatment by approach,patients in the study group were better,not only the operation and hospitalization time was shorter,but also the incision length was shorter than the control group,and the intraoperative blood loss was less than the control group(P<0.05);In terms of the satisfaction rate of reduction,the satisfaction rate of reduction in the study group was significantly higher than that in the control group(P<0.05);In terms of the incidence of complications,the number of complications in the study group was less,and the incidence of complications was lower(P<0.05).Conclusion Compared with the treatment method of inguinal approach,the effective treatment of patients with complex pelvic acetabular fracture by parabdominis approach is more ideal.On the one hand,it can optimize the hip function of patients,significantly reduce the hospitalization and operation time of patients,and save the cost of patients'surgery.On the other hand,it can also improve the satisfaction of patients with reduction and reduce the risk of complications.