复杂骨盆骨折手术治疗分析.docVIP

复杂骨盆骨折手术治疗分析 　　doi：10.3969/j.issn.1007-614x.2014.15.39 　　摘 要 目的：探讨复杂骨盆骨折患者采用内固定手术治疗的方法及效果。方法：2011年1月-2013年6月收治复杂骨盆骨折患者56例，作为研究对象，回顾性分析其临床资料，采用Tile分型标准进行分型处理，然后根据具体的类型采取对应的入路和内固定手术方法处理。术后随访9个月，采用Matta对疗效进行评价。结果：优30例，良21例，可5例，差0例，总优良率91.07%。结论：复杂骨盆骨折属于临床常见骨折疾病，治疗难度很大，应根据具体的骨折类型采取对应的入路与内固定术处理，才能取得更好的效果，提高患者生存质量及存活率。 　　关键词 复杂 骨盆骨折 入路 内固定术 　　To analyze operation treatment of complicated pelvic fracture 　　Yang Xinke 　　The first orthopedics department of the peoples hospital in Baoshan City，Yunnan Province，678000 　　Abstract Objective：To discuss the method and result of internal fixation operation treatment of complicated pelvic fracture.Methods： 56 cases of patients with complicated pelvic fracture were admitted from January 2011 to June 2013.As the research objects， clinical data of them were retrospectively analyzed.Use the Tile classification criteria，and then use corresponding approach and internal fixation operation treatment according to specific types to process. All cases were given9 months follow-up，and the curative effect was evaluated by using the Matta.Results： 30 cases were excellent， 21 cases were good， 5 cases were ok and 0 case was poor.The excellent rate was 91.07%.Conclusion：Complicated pelvic fracture is a common clinical fracture disease.Its treatment is very difficult.In order to achieve better result，improve the patients quality of life and survival rate，it should take into processing with corresponding approach and internal fixation based on the specific fracture type. 　　Key words Complicated；Pelvic fracture；Approach；Internal fixation 　　资料与方法 　　2011年1月-2013年6月收治骨盆骨折患者56例，Tile分型B型、C型及部分合并髋臼骨折或其他损伤的骨盆骨折定义为复杂骨盆骨折，该组患者56例作为研究对象，全部为不稳定型骨折患者，皆签署知情同意书愿意配合本次研究。56例患者中，男39例、女17例；年龄17～59岁，均值（37.9±5.8）岁；致伤原因：车祸伤35例，高空坠落伤12例，挤压伤9例；Tile分型，B1型7例，B2型27例，B3型12例及C型10例；并发症包括髋臼骨折22例，后脱位5例，髋关节中心性脱位7例，以及其他部位损伤（脑外伤、血气胸、尿道损伤、脾破裂等）21例，失血性休克13例。 　　方法：所有患者入院后皆立即进行伤情快速评估，同时急诊处理各类合并症，根据患者的骨盆与髋臼骨折移位情况，选取大重量股骨髁上骨进行牵引处理，于伤后5～12天，待病情稳定后进行内固定术，其中入路方式包括髂腹股沟入路、耻骨联合上入路、改良