[1]牟遐平,楚宇鹏,王金华,等.经皮空心螺钉固定与重建钢板固定治疗耻骨联合分离的比较研究[J].中医正骨,2011,23(10):21-23.
　MU Xia-ping*,CHU Yu-peng,WANG Jin-hua,et al.Comparative study on the percutaneous hollow screws fixation and reconstruction plate fixation in the treatment of pubic symphysis diastasis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(10):21-23.
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经皮空心螺钉固定与重建钢板固定治疗耻骨联合分离的 比较研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期数:
2011年10期
页码:
21-23
栏目:
临床研究
出版日期:
2011-10-31

文章信息/Info

Title:
Comparative study on the percutaneous hollow screws fixation and reconstruction plate fixation in the treatment of pubic symphysis diastasis
作者:
牟遐平1; 楚宇鹏2; 王金华3; 廖维3; 郭晓山3; 孔建中3
1.四川省简阳市人民医院,四川 简阳 641400; 2.浙江省温州市第二人民医院, 浙江 温州 325000; 3.温州医学院附属第二医院,浙江 温州 325027
Author(s):
MU Xia-ping*; CHU Yu-peng; WANG Jin-hua; et al.*
The People's Hospital of Jianyang City,Jianyang 641400,Sichuan,China
关键词:
耻骨联合分离 内固定器 治疗; 临床研究性
Keywords:
Pubic symphysis diastasis;  Internal fixators;  Therapies; Investigational
摘要:
目的:比较分析经皮空心螺钉固定与重建钢板固定治疗耻骨联合分离的临床疗效。方法:回顾性分析2002年1月至2008年6月,简阳市人民医院收治的44例耻骨联合分离患者的病历资料,其中24例采用经皮空心螺钉固定(A组),20例采用重建钢板固定(B组)。记录并比较2组患者的手术时间、术中出血量、切口长度、X线暴露次数及并发症发生情况,并根据Majeed功能评定标准评定2组患者的疗效。结果:①A组患者的术中出血量和切口长度小于B组(t=22.213,P=0.000; t=16.201,P=0.000),手术时间和X线暴露次数多于B组(t=5.427,P=0.000; t=9.155,P=0.000)。②2组患者疗效比较,差异无统计学意义(Z=0.317,P=0.751)。③A组有1例发生耻骨联合再分离,3例出现耻骨联合处疼痛; B组2例耻骨联合后区有轻微疼痛,2例出现螺钉松动。2组患者并发症发生情况比较,差异无统计学意义(P=1.000)。结论:经皮空心螺钉与重建钢板固定治疗耻骨联合分离疗效相当,安全性方面也无差异; 前者手术耗时长、X线暴露次数多,但手术切口小、术中出血量少。术者应根据自身操作技能水平、熟练程度和医院条件等综合考虑,选择适宜的内固定方式。
Abstract:
Objective:To make a comparative analysis on the clinical curative effects of percutaneous hollow screws fixation and reconstruction plate fixation in the treatment of pubic symphysis diastasis.Methods:The medical records of 44 patients with pubic symphysis diastasis treated in People's Hospital of Jianyang City from January 2002 to June 2008 were analyzed retrospectively.Twenty-four cases in group A were administrated with percutaneous hollow screws fixation,while the others in group B were administrated with reconstruction plate fixation.The operation time,amount of blood loss,incision length,X-ray exposure times and complications of patients were recorded and compared between the 2 groups,and the curative effects were evaluated according to Majeed functional evaluation standards.Results:①Amount of blood loss and incision length of patients in group A were all less than those of patients in group B(t=22.213,P=0.000; t=16.201,P=0.000),while the operation time and X-ray exposure times of group A were all more than those of group B(t=5.427,P=0.000; t=9.155,P=0.000).②There was no statistical difference in the curative effects between the 2 groups(Z=0.317,P=0.751).③One case with pubic symphysis rediastasis and 3 cases with pain in the place of pubic symphysis were found in group A; while 2 cases with mild pain in the back zone of pubic symphysis and 2 cases with loose screws were found in group B.There was no statistical difference in the complications between the 2 groups(P=1.000).Conclusion:Although the fixation with percutaneous hollow screws has the similar curative effects and safety to the fixation with reconstruction plate in the treatment of pubic symphysis diastasis,it has smaller incision and less amount of blood loss while needing longer time for the operation and more exposure times of X-ray,therefore,the operators should choose the appropriate internal fixation according to their own operation skills,proficiency levels and the hospital conditions.

参考文献/References:

[1] Majeed SA.Grading the outcome of pelvic fractures[J].J Bone Joint Surg Br,1989,71(2):304-306.
[2] Leighton RK,Waddell JP,Bray TJ,et al.Biomechanical testing of new and old fixation devices for vertical shear fractures of the pelvis[J].J Orthop Trauma,1991,5(3):313-317.
[3] Stocks GW,Gabel GT,Noble PC,et al.Anterior and posterior internal fixation of vertical shear fractures of the pelvis[J].J Orthop Res,1991,9(2):237-245.
[4] 郭晓山,池永龙.经皮闭合内固定治疗骨盆环损伤[J].中华外科杂志,2006,44(4):260-263.
[5] 周建明,章银灿,石高才,等.耻骨联合分离的治疗策略[J].中国骨伤,2008,21(1):58-59.

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更新日期/Last Update: 1900-01-01