白　哲

沈阳市骨科医院骨盆髋臼外科，辽宁沈阳110041

改良前入路髂腹股沟切口手术治疗骨盆及髋臼骨折的临床效果研究

白哲

沈阳市骨科医院骨盆髋臼外科，辽宁沈阳110041

目的探讨改良前入路髂腹股沟切口治疗骨盆及髋臼骨折的临床价值。方法50例患者均为2013年1月～2016年1月期间我院收治的骨盆及髋臼骨折患者，按照治疗方法将所有患者分为两组，其中Ⅰ组29例，采用标准前入路髂腹股沟切口手术治疗，Ⅱ组21例，采用改良前入路髂腹股沟切口手术治疗，比较两组切口暴露时间、术中出血量、切口关闭时间等术中指标及Majeed功能评分、骨盆骨折的复位效果。结果Ⅱ组切口暴露时间、切口关闭时间与Ⅰ组比较更短，术中出血量与Ⅰ组比较更少，两组差异有统计学意义（P＜0.05）。Ⅰ组Majeed功能评分总分与Ⅱ组比较更低，两组差异有统计学意义（P＜0.05）。Ⅰ组Matta评定优良率与Ⅱ组比较，差异无统计学意义（P＞0.05）。结论骨盆及髋臼骨折患者无论采用标准前入路髂腹股沟切口手术还是改良前入路髂腹股沟切口手术均可收到显著疗效，但改良前入路髂腹股沟切口手术操作更简单，对患者造成的损伤更小，可使手术时间明显缩短，术中出血量更少，可作为一种理想的手术入路应用于骨盆及髋臼骨折的治疗中。

骨盆；髋臼骨折；入路；髂腹股沟切口

［Abstract］Objective To investigate the clinical value of former modified approach groin incision pelvic and acetabular fractures.Methods 50 patients with pelvic and acetabular fractures were selected from January 2013 to January 2016 in our hospital，according to the methods of treatment all patients were divided into two groups，groupⅠhad 29 patients and they were treated with the standard approach before groin incision surgery，groupⅡhad 21 cases and they were treated with pre-modified approach groin incision surgery.The incision time，blood loss，cut-off time and other indicators surgery and Majeed score，pelvic fracture reset effect of two groups were compared.Results The cut exposure time，and cut off time of groupⅡwas shorter than groupⅠ，blood loss was less than groupⅠ，the difference was statistically significant（P＜0.05）.Majeed score of groupⅠwas lower than groupⅡ，the difference was statistically significant（P＜0.05）.There were no significant differences in Matta assess good rate between groupⅡand groupⅠ，the difference was not statistically significant（P＞0.05）.Conclusion Pelvis and acetabular fracture patients regardless of prestandard approach groin incision or modified before the groin incision approach can receive a significant effect，but the first modified approach groin incision operation easier，due to the use of the patient less damage，can significantly shorter operative time，less blood loss，can be used as an ideal surgical approach is applied to the pelvic and acetabular fracture treatment.

［Key words］Pelvis；Acetabular fractures；Approach；Groin incision

骨盆及髋臼骨折多是由于高能量损伤引起的，如车祸、高处坠落等［1］，两种骨折常常同时出现，有较高的致残率，治疗较为复杂，一般预后不理想，手术复位及有效固定是大部分发生移位的骨盆及髋臼骨折患者获得满意疗效的首选，手术成败的关键为骨折端暴露的是否充分、术野的暴露是否良好［2］。……