保留髂骨外形与传统髂骨取骨术的病例对照研究

目的:观察传统髂骨取骨和保留髂骨髂嵴两种取骨方式在自体植骨手术中的应用并探讨其有效性和安全性。方法：自2016年1月至2018年12月50例需行自体植骨患者分别采用传统髂骨取骨方式和保留髂骨髂嵴取骨方式进行髂骨取骨，每组25例，其中传统髂骨取骨组，男18例，女7例，年龄（42.0±7.9）岁，住院时间（20.0±5.5） d，随访时间（13.68±1.60）个月；保留髂骨髂嵴取骨组，男16例，女9例，年龄（44.0±8.2）岁，住院时间（21.0±6.5） d，随访时间（14.04±1.54）个月，比较两组患者取骨手术时间，术中出血量，术后疼痛视觉模拟评分（visual analogue scale，VAS），观察骨折愈合情况以及并发症。结果：传统髂骨取骨组手术时间为（16.20±2.51） min，术中出血量（63.20±17.73） ml，术后第1天VAS评分为4.72±1.21，骨折愈合时间（4.84±0.90）个月。保留髂骨髂嵴取骨组手术时间为（16.24±3.00） min，术中出血量（62.80±18.14） ml，术后第1天VAS评分为4.80±1.29，骨折愈合时间（4.68±0.80）个月。两组的手术时间、术中出血量、术后第1天VAS评分、骨折愈合时间比较，差异无统计学意义（P>0.05）。结论：与传统髂骨取骨手术相比，保留髂骨外形的取骨方式，简单方便，在保证取骨量的同时，尽可能的保留了髂骨的髂嵴外形，减少术后局部不适症状，值得推广。

A case-control study of preserving the shape of iliac bone and traditional iliac osteotomy

Objective: To compare and study the traditional iliac bone extraction and iliac crest preserving bone extraction, and to observe their curative effects.Methods: From January 2016 to December 2018, 50 patients were treated with traditional iliac bone extraction and iliac crest preserving iliac bone extraction, with 25 cases in each group. In the traditional iliac bone extraction group, there were 18 males and 7 females, aged (42.0±7.9) years, hospitalized for (20.0±5.5) days and followed up for (13.68±1.60) months. There were 16 males and 9 females in the iliac crest preserving osteotomy group, aged (44.0±8.2) years, hospitalized for (21.0±6.5) days and followed up for (14.04±1.54) months. The operation time, intraoperative bleeding, postoperative pain visual analgue scale(VAS), fracture healing and complications were recorded and compared between the two groups.Results: In the traditional iliac bone extraction group, the operation time was (16.20±2.51) min, the amount of bleeding was (63.20±17.73) ml, the VAS score on the first day after operation was 4.72±1.21, and the fracture healing time was (4.84±0.90) months. In the iliac crest preserving osteotomy group, the operation time was (16.24±3.00) min, the amount of bleeding was (62.80±18.14) ml, the VAS score was 4.80±1.29 on the first day after operation, and the fracture healing time was (4.68±0.80) months. There was no significant difference in operation time, bleeding volume, pain VAS on the first day after operation and fracture healing time between the two groups(P>0.05).Conclusion: Compared with the traditional iliac bone removal surgery, this bone removal method of preserving the appearance of iliac bone is simple and convenient. While ensuring the amount of bone removal, it retains the appearance of iliac crest as much as possible and reduces local discomfort symptoms after operation. It is worth popularizing.