摘要
目的探讨暂时性腹主动脉球囊阻断术在陈旧性髋臼骨折切开复位内固定手术中应用价值：方法2000年6月至2011年6月采用前后联合入路切开复位内固定治疗44例陈旧性髋臼骨折患者，2006年以后收治的23例患者中17例接受暂时性腹主动脉球囊阻断术以控制术中出血（阻断组），男10例，女7例；平均年龄为（33．5±1．8）岁。骨折AO分型：B1型3例，B2型4例，B3型2例，C型8例。以2006年以前收治且未接受暂时性腹主动脉球囊阻断术的21例患者作为对照组，男12例，女9例；平均年龄为（31．2±2．4）岁。骨折AO分型：B1型5例，B2型7例，B3型3例，C型6例。记录并比较两组患首平均手术时间、出血量、输血量、复位优良率及术后功能优良率。结果阻断组患者腹主动脉阻断时间平均为（48．5±18．9）min。阻断组和对照组患者平均手术时间、术中出血量及术中输血量比较差异均有统计学意义（P〈0．05）。术后复位优良率根据改良的Matta复位标准评定：阻断组为82．4％（14／17），对照组为81．0％（17／21），两组比较差异无统计学意义（P=0．323）。35例患者术后获12-30个月（平均18．4个月）随访。未次随访时根据改良Merle d’Aubigne和Postel评分标准评定患髋功能：阻断组优9例，良4例，可2例，差1例，优良率为81．3％；对照组优10例，良4例，可3例，筹2例，优良率为73．7％。两组比较差异无统计学意义（P=0．277）。结论陈旧性髋臼骨折术巾应用暂时性腹主动脉球囊阻断术能更有效地控制术中出血、缩短手术时间，是一项有效的止血措施。
Objective To explore the efficacy of temporary balloon occlusion of the abdominal aorta during open reduction and internal fixation of delayed acetabular fractures. Methods From June 2000 to June 201 I. 44 patients with delayed acetabular fractures were surgically treated through combined approaches （ilio-inguinal approach and Koeher-Langenbeck approach） in our hospital. Seventeen patients who underwent temporary, balloon occlusion of the abdominal aorta after 2006 were assigned into group A. They are 10 males and 7 fcmales, with an average age of 33.5 ± 1.8 years. According to AO classification, 3 cases were of type B1, 4 cases of type B2, 2 cases of type B3 and 8 cases of type C. The other 21 patients before 2006 were in the control group （group B）. They were 12 males and 9 females, with an average age of 31.2 ± 2.4 years. According to AO classification, 5 cases were of type B1, 7 cases of type B2, 3 cases of type B3 and 6 cases of type C. Average operation time, intra-operative blood loss, blood transfusion, satisfactory, reduction rate and functional recovery were recorded and compared between the 2 groups. Results The average time of blood flow occlusion was 48.5± 18.9 minutes in group A. In terms of operation time, intra-operative blood loss and blood transfusion, group A was significantly better than group B （ P 〈 0. 05） . By Matta evaluation system, the satisfactory, reduction rate was 82.4% in group A and 81.0% in group B, with no significant diff＇erence （P = 0. 323）. Thirty-five patients were followed up from 12 to 30 months, with an average time of 18.4 months. By the Merle d＇ Aubigne and Postel evaluation system at the last follow-up, the good to excellent rates of functinnal recovery were 81.3% in group A and 73.7% in group B, with no significant difference （ P = 0. 277）. Conclusion In treatment of delayed aeetabular fractures, temporary balloon occlusion of the abdominal aorta is a reliable technique to control bleeding because it can reduce the intra-operative blood los
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2012年第5期376-380,共5页
Chinese Journal of Orthopaedic Trauma
关键词
髋臼
骨折
主动脉
腹
阻断疗法
出血
Acetabulum
Fractures, bone
Aorta, abdominal
Withholding treatment
Hemorrhage
