摘要
目的 研究股骨髁骨折合并中重度颅脑损伤患者手术时机的制定.方法 自2007年6月-2012年3月,我院对47例患者股骨髁骨折进行了手术治疗.手术方法为外固定架（2例）,倒打钉（3例）,动力髁钢板（16例）,股骨髁解剖钢板19例,拉力螺钉或空心钉固定（7例）.按照入院时GCS评分分三组,第一组,9-10分,17例;第二组,6-8分,20例;第三组,5分以下,10例.统计各组平均等待手术时间.按照手术时GCS评分分二组,第一组,9分以上,37例;第二组,5-8分,10例.统计各组平均等待手术时间.按照平均等待手术时间分三组,小于14天手术患者,15-28天之间手术患者,超过28天手术患者,对各组平均实施手术时间及术后切口引流量进行统计.随访8个月,每个月患肢拍x光片,记录手术后第三个月膝关节功能,每个组之间在进行相关性分析统计.结果 入院时GCS评分分组,三组平均等待手术时间分别为13.4天、24.9天、36.6天.手术时GCS评分分组,两组平均等待手术时间分别为19.6天、36.6天.按照平均等待手术时间分组,三组平均实施手术时间分别为88.8m、112.6m、152.4m;三组术后切口的平均引流量分别为237.6ml、570.8ml、825.3ml.膝关节功能：优12例,良21,可6,差12例.再根据每个组相关性分析得GCS评分与等待手术时间天密切相关,相关系数为0.92.结论 颅脑损伤评分为9分,手术等待时间在14以内为最佳手术时机,此时手术时间短,出血量少,术后关节功能恢复好.
Objective To study patients formulation of operations＇opportunity with condylar fracture combined moderately severe brain injury. Method From 6 months in 2007 years to 3 months in 2012 years, forty-seven patients with moderately or severe brain injury had received surgery for condylar fracture. Operation way included external fixator （2 cases）, reverse intramedullary nail fixation （3 cases）, dynamic condylar screw fixation（16 cases）, femoral condylar anatomy plate fixation（19 cases）, lag screw or hollow screw fixation（7 cases）. According to GCS at registered time, dividing three groups, the first group ,9-10scores, 17 cases; the second group, 6-8 scores, 20 cases; the third group, less than 5 scores, 10 cases; to statistics each group the average waiting operation time. According to the GCS scores at operation, dividing two groups, the first, more than 9 scores, 37 cases; the second group, 5-8 scores, 10 cases; to statistics each group the average waiting operation time. According to the average waiting operation time, dividing three groups, the first group is less than 14 days; the second group is between 15 and 28 days and the third group is more than 28 days, to stastics each group average operation time and quantity of incision flow postoperation. Followed 8 months, told the patients take X gray film to reserve the union. Recording the third month knee functions, its functions criteria were formulated according to Shelbourne. Each group had done correlation analytic statistics. Results According to GCS at registered time, every group has respectively waiting operating time 13.4d,24..9d,36.6d; According to the GCS scores at operation, every group has respectively waiting operating timel9.6d, 36.6d. According to the average waiting operation time, every group had respectively time, 88.8m,112.6m,152.4m; every group had respectively quantity of incision flow postoperation, 237.6ml,570.8ml、825.3ml. Knees fimctions divided excellent 12 cases, good 21 cases, fair 6 cases, poor 12 cases. Each
出处
《医药与保健》
2014年第2期12-13,15,共3页
Medicine and Health Care
关键词
股骨髁骨折
颅脑损伤
手术时机
研究
femur condylar fracture
brain injury
operation opportunity
research
