经皮骶髂关节空心螺钉内固定联合支架外固定治疗骨盆骨折的临床效果分析

目的:探讨经皮骶髂关节空心螺钉内固定联合支架外固定在骨盆骨折中的临床疗效.方法:选取2015年1月-2017年1月佳木斯大学附属第一医院骨外二科收治的经皮骶髂关节空心螺钉内固定联合支架外固定治疗的40例患者(内外固定组),同期收治的采用开放手术治疗的40例骨盆骨折患者(开放手术组)作对照.术后,观察分析两组患者的手术相关指标、Majeed功能评分、临床疗效以及术后并发症发生情况.结果:内外固定组患者的手术时间、术后下床时间均显著短于开放手术组,术中出血量显著少于开放手术组,Majeed功能评分显著高于开放手术组,差异均有统计学意义(P＜0.05).内外固定组患者的治疗总有效率为90.0％(36/40例),显著高于开放手术组的65.0％(26/40例),差异有统计学意义(P＜0.05).内外固定组患者的术后并发症发生率为7.5％(3/40例),显著低于开放手术组的20.0％(8/40例),差异有统计学意义(P＜0.05),术后并发症主要有感染、骨关节炎、下肢深静脉血栓.结论:经皮骶髂关节空心螺钉内固定联合支架外固定相较于开放手术,能够有效缩短手术时间、减少术中出血量、提高治疗优良率及降低术后并发症发生率,值得在临床上推广应用.

Therapeutic effect of percutaneous internal fixation with sacroiliac joint hollow screw combined with external fixator for pelvic fracture

Objective:To investigate the clinical effect of percutaneous internal fixation with sacroiliac joint hollow screw combined with external fixator in treatment of pelvic fracture.Methods:Forty patients with pelvis fracture admitted in the First Affiliated Hospital of Jiamusi University from Jan.2015 to Jan.2017 received percutaneous internal fixation with sacroiliac joint hollow screw combined with external fixator (internal and external fixation group),while 40 patients underwent open surgery followed by an external fixation (open surgery group) admitted in the same period were served as controls.The operation time,intraoperative blood loss,postoperative ambulation time,Majeed score,clinical efficacy and the incidence rate of postoperative complications were analyzed for the two groups.Results:The operation time and the postoperative ambulation time were significantly shorter,the intraoperative blood loss was obviously less and the Majeed score was markedly higher in the internal and external fixation group than in the open surgery group with statistical significance (P＜0.05).In the internal and external fixation group,the total efficiency rate was higher (90.0％,36/40 cases) and the incidence rate of postoperative complications was lower (7.5％,3/40 cases) than in the open surgery group (65.0％,26/40 cases and 20.0％,8/40 cases,respectively) with statistical significance (P＜0.05).The main postoperative complications were infection,osteoarthritis and deep vein thrombosis.Conclusions:Compared with the treatment of open surgery,the therapeutic effect of percutaneous internal fixation with sacroiliac joint hollow screw combined with external fixator can effectively shorten operative time,reduce the amount of intraoperative blood loss,improve the excellent rate of treatment and reduce the incidence of postoperative complications,so is worth to use in treatment of pelvic fracture.