肠道准备对经皮横向骶髂关节螺钉固定的影响

[目的]探讨肠道准备对经皮横向骶髂螺钉固定的影响。[方法]2015年8月~2018年12月,30例骶骨骨折行经皮横向S1骶髂关节螺钉置入治疗的患者纳入本研究,采用随机数字表法将患者分为两组,每组15例,准备组患者术前接受肠道准备,无准备组患者术前未接受肠道准备。比较两组手术时间、术中透视次数和曝光时间,以及影像测量的置钉偏差。[结果]准备组的手术时间显著短于无准备组,差异有统计学意义[(32.31±4.92)min vs(40.54±5.83)min,P<0.05)];准备组的术中X线暴露时间显著短于无准备组,差异有统计学意义[(62.59±5.79)s vs(83.19±6.41)s,P<0.05];准备组的术中透视次数显著少于无准备组,差异有统计学意义[(3.71±0.58)次vs(5.21±1.11)次,P<0.05]。术后CT三维重建测量螺钉与术前测量偏移方面,准备组的水平偏移小于无准备组,但差异无统计学意义[(5.53±2.21)°vs(5.63±1.97)°,P>0.05];准备组矢状位偏移小于无准备组,但差异无统计学意义[(4.32±2.08)°vs(4.52±1.91)°,P>0.05]。术后随访6~12个月,所有患者均未发生骶髂关节螺钉松动及断裂等并发症。[结论]肠道准备虽不能提高置钉准确率,但能够缩短手术时间和术中X线暴露时间。

Effect of bowel preparation on percutaneous transverse iliosacral screw fixation for longitudinal sacral fractures

[Objective]To evaluate the effect of bowel preparation on percutaneous transverse iliosacral screw fixation for longitudinal sacral fractures.[Methods]From August 2015 to December 2018,a total of 30 patients who were undergoing percu⁃taneous transverse iliosacral screw fixation for longitudinal sacral fractures in our hospital were enrolled into this study,and di⁃vided into two groups by random number table method,with 15 patients in each group.Of them,15 patients in the preparation group received bowel preparation,while the remaining 15 patients in non-preparation group had no bowel preparation before op⁃eration.The operation time for iliosacral screw placement,frequency and time of X-ray exposed,as well as deviation of screw in⁃sertion measured on radiographs were compared between the two groups.[Results]The preparation group consumed significant⁃ly shorter operation time than the non-preparation group[(32.31±4.92)min vs(40.54±5.83)min,P<0.05)].In addition,the preparation groups got significantly shorter X ray exposure time than the non-preparation group[(62.59±5.79)s vs(83.19±6.41)s,P<0.05].Furthermore,the preparation group had significantly less frequency of fluoroscopy than the non-preparation group[(3.71±0.58)vs(5.21±1.11),P<0.05].In terms of deviations of iliosacral screw placement compared the postoperative CT imag⁃es with the preoperative design,the preparation group had slightly less horizontal deviation than the non-preparation group re⁃gardless of no a statistical difference between them[(5.53±2.21)°vs(5.63±1.97)°,P>0.05],whereas the preparation group had slightly less sagittal deviation than the non-preparation group without a a statistical difference between them[(4.32±2.08)°vs(4.52±1.91)°,P>0.05].During the follow up period ranged from 6 to12 months,no loosening or breaking of the screw was noted in any patients of both groups.[Conclusions]Bowel preparation is helpful to reduce the operation time of and X-ray exposure in percutaneous iliosacral screw inser⁃tion,nevertheless not significantly improve the accuracy of screw placement.