杨永华 胡斌 杨海龙 杨敏捷 高展望

[摘要] 目的 探讨C臂机透视下骨盆骨折经皮空心螺钉内固定的临床应用价值。 方法 选取2015年7月至2016年12月九江市第一人民医院80例骨盆骨折患者作为研究对象，按照随机数字表法分为观察组（C臂机透视下经皮空心螺钉内固定治疗）与对照组（传统切开复位内固定手术治疗）两组，每组各40例。比较两组患者手术指标、治疗前后VAS评分、majeed评分，随访术后并发症发生率。 结果 观察组患者手术时间、术后下床活动时间及住院时间均短于对照组，术中出血量少于对照组，差异有统计学意义（P<0.05）;两组患者治疗前VAS评分、majeed评分比较，差异无统计学意义（P>0.05），治疗后观察组VAS评分和majeed评分均优于对照组，差异有统计学意义（P<0.05）;观察组患者并发症发生率为5.0%（2/40），低于对照组的22.5%（9/40），差异有统计学意义（P<0.05）。 结论 C臂机透视下经皮空心螺钉内固定应用于Tile B型、C型骨盆骨折患者，创伤小、术后恢复快，在缓解疼痛、提升术后骨盆功能方面有突出效果，并发症少，应掌握其适应证，发挥该术式的优势。

[关键词] C臂机透视;经皮空心螺钉内固定;骨盆骨折;VAS评分;majeed评分;并发症

[中圖分类号] R684.1          [文献标识码] B          [文章编号] 1673-9701（2021）30-0074-03

[Abstract] Objective To explore the clinical application value of percutaneous hollow screw internal fixation in pelvic fracture under C-arm fluoroscopy. Methods Eighty patients with pelvic fracture from July 2015 to December 2016 in Jiujiang NO.1 People′s Hospital were selected as the study subjects. They were divided into the observation group （percutaneous hollow screw internal fixation under C-arm fluoroscopy） and the control group （traditional open reduction and internal fixation） according to random number table，with 40 cases in each group.The surgical indicators， VAS score before and after treatment，majeed score，and the incidence of postoperative complications were compared between the two groups. Results The operation time， postoperative off-bed activity time and hospital stay in the observation group were shorter than those in the control group，and the differences were statistically significant（P<0.05）. The differences in VAS score and majeed score before treatment between the two groups were not statistically significant（P>0.05）. The VAS score and majeed score after treatment in the observation group were superior to those in the control group， and the differences were statistically significant（P<0.05）.The incidence rate of complications in the observation group was 5.0%（2/40）， lower than 22.5% （9/40） in the control group， and the differences was statistically significant（P<0.05）. Conclusion The application of percutaneous hollow screw internal fixation under C-arm fluoroscopy in patients with Tile type B and C pelvic fractures has the advantages of small trauma， rapid postoperative recovery.It has outstanding effects in relieving pain and improving postoperative pelvic function， with few complications. The indications should be mastered and the advantages of the procedure should be exerted.

[Key words] C-arm fluoroscopy; Percutaneous hollow screw internal fixation; Pelvic fracture; VAS score; majeed score; Complications

作为临床常见的骨折类型，骨盆骨折在全身骨折中占3%～5%，多由暴力创伤对骨盆产生挤压所致，伤情重、预后差，患者多伴随多发性损伤，若治疗不及时或治疗方案不当将会诱发失血性休克、盆腔脏器合并伤，严重者甚至威胁到患者生命安全[1]。文献报道，盆腔组织存在较多脏器，再加上骨盆结构的复杂性，手术存在较高的风险[2]。……