摘要
目的:探讨不同入路手术对骨盆髋臼骨折患者骨折复位质量、髋关节功能及炎症因子的影响。方法:回顾性分析2016年7月~2018年12月期间我院收治的91例骨盆髋臼骨折患者的临床资料,根据入路方式的不同将其分为A组(n=44,髂腹股沟入路)和B组(n=47,改良Stoppa入路),比较两组患者复位质量、围术期指标、髋关节功能及炎症因子水平,记录两组患者随访期间并发症发生情况。结果:B组术中出血量少于A组,手术切口长度短于A组(P<0.05);两组手术显露时间比较差异无统计学意义(P>0.05)。B组的骨折复位优良率为85.11%(40/47),高于A组的65.91%(29/44)(P<0.05)。与术前相比,两组患者出院时、术后6个月的改良Postel评分成逐渐升高趋势(P<0.05);两组患者术前、出院时、术后6个月的改良Postel评分组间比较差异无统计学意义(P>0.05)。两组患者术后7 d血清白介素-6(IL-6)、降钙素原(PCT)水平均高于术前,但B组低于A组(P<0.05)。B组随访期间并发症发生率低于A组(P<0.05)。结论:改良Stoppa入路手术与髂腹股沟入路手术均可改善骨盆髋臼骨折患者髋关节功能,但经改良Stoppa入路手术者骨折复位质量更佳,创伤更小,炎症反应更轻,同时还可减少并发症发生率。
Objective: To investigate the effects of different approaches on the reduction quality, hip function and inflammatory factors of patients with pelvic and acetabular fractures. Methods: The clinical data of 91 patients with pelvic and acetabular fractures who were admitted to our hospital from July 2016 to December 2018 were analyzed retrospectively. According to the different approaches,they were divided into group A(n=44, ilioinguinal approach) and group B(n=47, modified Stoppa approach). The reduction quality, perioperative indexes, hip joint function and inflammatory factors were compared between the two groups. The complications of the two groups were recorded during the follow-up. Results: The intraoperative hemorrhage in group B was less than that in group A, the length of incision was shorter than that in group A(P<0.05). There was no significant difference in operative exposure time between the two groups(P>0.05). The excellent and good rate of fracture reduction in group B was 85.11%(40/47), which was higher than 65.91%(29/44)in group A(P<0.05). Compared with before treatment, the modified Postel scores of the two groups increased gradually at the time of discharge and 6 months after operation(P<0.05). There was no significant difference between the two groups in the modified Postel score before operation, at the time of discharge and 6 months after operation(P>0.05). The serum levels of interleukin-6(IL-6), procalcitonin(PCT) in the two groups at 7 d after operation were higher than those before operation, but those in group B were lower than those in group A(P<0.05). The incidence of complications in group B was lower than that in group A(P<0.05). Conclusion: Both the modified Stoppa approach and the ilioinguinal approach can improve the hip joint function of patients with pelvic and acetabular fractures, but the improved Stoppa approach has better quality of fracture reduction, less trauma, less inflammatory response, and it can also reduce the incidence of complications.
作者
韩力
赵建文
王晓伟
何红英
吴卓
张建政
HAN Li;ZHAO Jian-wen;WANG Xiao-wei;HE Hong-ying;WU Zhuo;ZHANG Jian-zheng(Department of Orthopaedics,The SeventhMedical Center of Chinese People's Liberation Army General Hospital,Beijing,100700,China)
出处
《现代生物医学进展》
CAS
2020年第7期1289-1292,共4页
Progress in Modern Biomedicine
基金
中央军委后勤保障部重点项目(BLJ18J006)。
