改良Stoppa入路手术治疗髋臼骨折的疗效分析

发布时间：2018-04-21 23:37

本文选题：手术入路 + 髋臼骨折　；参考：《青海大学》2017年硕士论文

【摘要】：目的:选择2种不同手术入路治疗髋臼骨折的效果分析。方法:随机选取自2014年8月至2016年12月在我院接受髋臼骨折手术治疗的28例患者作为研究对象,14例选择改良的Stoppa的手术入路治疗,其余的进行髂腹股沟手术入路治疗。2组研究对象至少随访1年,改良的Stoppa的手术入路者为研究组,髂腹股沟手术入路者为常规组。对比2组研究对象的基本资料,及手术相关情况,如术中失血量、手术麻醉时间和术后疗效等。同时对上述的各情况逐个进行分析对比。并相比了二组随访3、6、12个月,随访时的髋关节Merled’Aubigne结果,对这两种入路治疗的效果做了比较。结果:1、两组调研对象的手术都顺利完成,且对二组对象的基本资料分析无统计差别(P0.05)。术前骨折分型也不存在统计学差别(P0.05)。2、和常规组相比,研究组中的手术持续时间、失血量都相对较少,切口长度也显得更短,存在统计学差别(P0.05)。对二组患者均进行了随访,随访结果不存在统计学差异。常规组中有少数患者出现患肢肿胀情况,进行抬高处理后症状消退,二组在治疗时期都没有出现死亡情况。3、术后24小时-72小时内拔除切口负压引流管,然后行骨盆前后位、髂骨斜位X线片等影像学检查,确定出相对应的复位Matta评分,结果二组的上述数据没有统计学差别(P0.05)。两组研究对象的三个时间点的随访Merled’Aubigne评分都无统计学差别(P0.05)。4、研究组病人中有1例出现并发症,另一组中有5例,二组之间有统计学差别(P0.05)。结论:改良的Stoppa手术入路处理髋臼骨折可以更好的暴露骨折的断端,对骨折对位固定和恢复都有很好的促进作用,且治疗过程中出现的并发症也明显少。
[Abstract]:Objective: to analyze the effect of two different operative approaches in the treatment of acetabular fractures. Methods: from August 2014 to December 2016, 14 patients with acetabular fractures received surgical treatment in our hospital were randomly selected. 14 patients were treated with modified Stoppa approach. The other two groups were followed up for at least one year by ilioinguinal approach. The modified Stoppa approach was the study group and the ilioinguinal operation approach was the routine group. The basic data of the two groups were compared, and the operative conditions, such as blood loss during operation, time of anesthesia and curative effect after operation, were compared. At the same time, each of the above situation is analyzed and compared one by one. The results of Merled'Aubigne of hip joint were compared between the two groups for 6 months and 12 months, and the effects of the two approaches were compared. Results the operation was successfully completed in both groups, and there was no statistical difference in basic data analysis between the two groups (P 0.05). There was no statistical difference in preoperative fracture classification (P 0.05). Compared with the control group, the operative duration, blood loss and incision length in the study group were relatively small, and there was statistical difference between the two groups. Two groups of patients were followed up, there was no statistical difference in follow-up results. In the routine group, a few patients had swelling of the affected limb, and the symptoms subsided after elevation treatment. There was no death in the two groups during the treatment period. The incision negative pressure drainage tube was pulled out within 24 hours to 72 hours after the operation, and then the pelvic anterior and posterior position was taken. The corresponding reduction Matta score was determined by radiography of iliac oblique position. Results there was no statistical difference in the above data between the two groups (P 0.05). There was no significant difference in the Merled'Aubigne scores between the two groups at three time points (P 0.05). One patient in the study group had complications and five in the other group. There was a significant difference between the two groups (P 0.05). Conclusion: modified Stoppa approach can better expose the broken end of acetabular fracture, promote the fixation and recovery of the fracture, and have fewer complications in the course of treatment.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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