切开复位内固定与牵引复位外固定支架固定治疗骨盆骨折疗效对比

Comparison of Clinical Efficacy between Open Reduction⁃internal Fixation and Traction Reduction⁃external Fixator Fixation in the Treatment of Pelvic Fracture

目的对比分析切开复位内固定与牵引复位外固定支架固定治疗骨盆骨折的临床疗效。方法选取2018年1月至2020年4月铁岭市中心医院收治的72例骨盆骨折患者作为研究对象,按照随机数表法将其随机分为内固定组(36例)与外固定组(36例),内固定组患者采用切开复位内固定治疗,外固定组患者采用牵引复位外固定支架固定治疗,对比观察两组患者切口长度等手术相关指标、引流管拔除时间等治疗情况、应激反应水平、术后髋关节功能恢复情况及并发症发生情况。结果内固定组患者切口长度、手术时间、引流管拔除时间、住院时间以及骨折愈合时间均明显长于外固定组(t=3.801、12.001、6.065、5.818、4.396,P均<0.001),术中出血量明显多于外固定组(t=12.230,P<0.001);术后1周,内固定组患者血清皮质醇(Cor)、促甲状腺激素(TSH)及肾上腺素(AD)水平均明显高于外固定组(t=11.852、22.016、10.963,P均<0.001);术后6个月,内固定组患者髋关节功能恢复优良率为77.78%,明显低于外固定组患者的髋关节功能恢复优良率94.44%(χ^(2)=4.181,P=0.041);内固定组患者术后并发症发生率为11.11%,与外固定组患者的术后并发症发生率5.56%无明显差异(χ^(2)=0.727,P=0.394)。结论与切开复位内固定相比,牵引复位外固定支架固定治疗骨盆骨折可明显减轻机体应激反应,加快术后机体功能恢复,提高临床疗效。

Objective To compare the clinical efficacy of open reduction⁃internal fixation and traction reduction⁃external fixator fixation in the treatment of pelvic fracture.Methods 72 patients with pelvic fracture admitted to Tieling Central Hospital from January 2018 to April 2020 were enrolled as research subjects,and were divided into internal fixation group(n=36)and external fixation group(n=36)using the random number table.Patients in the internal fixation group were treated with open reduction⁃internal fixation,while patients in the external fixation group were treated with traction reduction⁃external fixator fixation.The following items,including surgery⁃related indexes such as incision length,removal time of drains,stress response level,recovery of hip joint function after surgery,and occurrence of complications,were compared between the two groups.Results Compared with the external fixation group,the incision length,operation time,removal time of drains,length of stay,and fracture healing time of patients were all significantly longer in the internal fixa⁃tion group(t=3.801,12.001,6.065,5.818 and 4.396,all P<0.001),and the intraoperative blood loss was much more(t=12.230,P<0.001).One week after surgery,the levels of serum cortisol(Cor),thyroid⁃stimulating hormone(TSH)and adrenaline(AD)of patients in the internal fixation group were all significantly higher than that in the external fixation group(t=11.852,22.016 and 10.963,all P<0.001);6 months after surgery,the good and excellent rate of hip joint function recovery was 77.78%in the internal fixation group,which was significantly lower than the corresponding 94.44%in the external fixation group(χ^(2)=4.181,P=0.041);the incidence of postoperative complications of patients was 11.11%in the internal fixation group,showing no significant difference as compared with the corresponding 5.56%in the external fixation group(χ^(2)=0.727,P=0.394).Conclusion Compared with open reduction⁃internal fixation in the treatment of pelvic fracture,the traction reduction⁃external fixator fixation can significantly reduce the body’s stress response,accelerate postoperative recovery of body functions,and realize better clinical efficacy.