不完全性半骨盆离断伤评估表的制定及其临床指导价值

发布时间：2018-10-14 19:32

【摘要】：研究目的:探讨不完全性半骨盆离断伤的急救策略;制定不完全性半骨盆离断伤评估表,探讨其对指导治疗不完全性半骨盆离断伤的价值。研究方法:回顾性分析2003年1月至2015年12月,治疗14例不完全性半骨盆离断伤患者资料,男10例,女4例;年龄21～55岁,平均31岁;11例为急诊入院,3例为外院转入;Tile分型均为C型骨盆骨折,其中C1型9例,C2型3例,C3型2例。根据患者软组织的损伤程度、骨性结构离中轴距离、髂血管损伤程度以及神经损伤程度四项标准对患者进行伤情评估,每一项评估标准按损伤程度分为四级,分别对应1～4分,总分16分,制定半骨盆离断伤评估量表;其中评分12分,则立即行半骨盆离断术;8评分≤12分,则根据实际情况再次评估,并建议行半骨盆离断术;4评分≤8分,则尽力保肢;评分≤4分,则绝对保肢。研究结果:14例患者按半骨盆离断评估量表进行评价,评分为9～15分,平均11分;其中9～12分12例,超过12分2例,均应行半骨盆离断术。14例患者中,3例在急救复苏阶段死亡;7例在出血得到控制后,早期行半骨盆离断术,全部抢救成功;4例尝试保肢或保留半侧骨盆,其中3例因感染而死亡,1例在一期半髋离断术后第3天因感染而二期行半骨盆离断术,术后存活。研究结论:半骨盆离断伤评估量表可以早期迅速、准确地对不完全半骨盆离断伤进行评估,明确诊断,有助于指导急救流程;在休克得到控制后,早期进行半骨盆离断术,可以提高急救的成功率。
[Abstract]:Objective: to explore the first aid strategy of incomplete hemipelvic dissection, to establish the evaluation table of incomplete hemipelvic fracture, and to explore its value in guiding the treatment of incomplete hemipelvic fracture. Methods: from January 2003 to December 2015, 14 patients (10 males and 4 females) with incomplete hemipelvic dissection were retrospectively analyzed. The average age was 31 years, 11 cases were admitted to emergency department, 3 cases were transferred to external hospital, 9 cases were type C1, 3 cases were type C2 and 2 cases were type C3. According to the degree of soft tissue injury, the distance of bone structure from the central axis, the degree of injury of iliac blood vessel and the degree of nerve injury, the patients were evaluated according to the degree of injury, each of which was divided into four levels according to the degree of injury. The scale for evaluation of hemipelvis disconnection injury was formulated with a score of 1 ~ 4, with a total score of 16 points, in which 12 points were scored, half pelvic dissection was performed immediately, and 8 points 鈮，

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