高位髂腹股沟入路治疗Tile C型骨盆骨折的应用解剖及临床疗效

doi:10.13418/j.issn.1001-165x.2020.04.020

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (4) : 471-475. DOI: 10.13418/j.issn.1001-165x.2020.04.020

临床研究

高位髂腹股沟入路治疗Tile C型骨盆骨折的应用解剖及临床疗效

姜铧财，　龙雳，　李森

作者信息 +

Applied anatomy and clinical efficacy of high ilioinguinal approach in the treatment of tile C-type pelvic fractures

JIANG Hua-cai, LONG Li, LI Sen

Author information +

文章历史 +

摘要

目的　研究高位髂腹股沟入路手术在Tile C型骨盆骨折临床治疗中的应用价值。方法　选取70例Tile C型骨盆骨折患者作为研究对象，其中A组35例，采用经高位髂腹股沟入路手术；B组35例，采用单纯后入路手术进行治疗。比较两组治疗优良率、满意率、术中出血量、切口长度、手术时间、下地时间、住院时间以及并发症发生率。结果　优良率，A组为88.57%，B组为65.71%，A组高于B组（P<0.05）。满意率，A组为97.14%，B组为74.29%，A组高于B组（P<0.05）。术中出血量、切口长度、手术时间、下地时间以及住院时间方面，A组优于B组（P<0.05）。并发症发生率，A组为2.86%，B组为22.86%，A组低于B组（P<0.05）。结论　对Tile C型骨盆骨折患者的治疗，经高位髂腹股沟入路手术效果显著且安全性高，具有较高的临床应用和推广价值。

Abstract

Objective　To study the applied value of high ilioinguinal approach in the clinical treatment of Tile C type pelvic fractures. 　Methods　In this study, 35 patients with Tile C type pelvic fractures were selected as subjects of group A, which were treated by high ilioinguinal approach, while other 35 patients with Tile C type pelvic fractures were selected as subjects of group B, which were treated by simple posterior approach. After the treatment, the excellent and good rate, satisfaction rate, intraoperative blood loss, incision length, operation time, length of stay, time of hospitalization and incidence of complications were compared between the two groups. 　Results　In terms of excellent and good rate, group A was 88.57%, group B was 65.71%, group A was higher than group B (P<0.05). In terms of satisfaction rate, group A was higher than that of group B (P<0.05) (Group A was 97.14%, group B was 74.29%). The volume of intraoperative blood loss, the length of incision, the time of operation, the time of going to the ground and the time of hospitalization in group A were all lower than that in group B (P<0.05). In terms of the incidence of complications, group A was 2.86%, group B was 22.86%, thus group A was lower than group B (P<0.05). Conclusions　In the treatment of Tile C type pelvic fractures, the treatment with the high ilioinguinal approach has the advantages of significant effect and high safety, so it has a high clinical application and promotion value.

导出引用

姜铧财, 龙雳, 李森. 高位髂腹股沟入路治疗Tile C型骨盆骨折的应用解剖及临床疗效[J]. 中国临床解剖学杂志. 2020, 38(4): 471-475 https://doi.org/10.13418/j.issn.1001-165x.2020.04.020

JIANG Hua-cai, LONG Li, LI Sen. Applied anatomy and clinical efficacy of high ilioinguinal approach in the treatment of tile C-type pelvic fractures[J]. Chinese Journal of Clinical Anatomy. 2020, 38(4): 471-475 https://doi.org/10.13418/j.issn.1001-165x.2020.04.020

中图分类号： R683.3

参考文献

[1] 顾荣, 王海文, 江新民, 等. 髂腹股沟穿支皮瓣移植修复四肢皮肤软组织缺损[J]. 中国临床解剖学杂志, 2017, 35(2): 42-44.
[2] 薛威. 不同手术方法治疗TileB-C型骨盆骨折的临床效果观察[J]. 临床和实验医学杂志, 2017, 5(4): 77-79.
[3] 陈开放, 杨帆, 郭晓东, 等. 髋臼四方区组合钢板治疗老年髋臼骨折的有效性[J]. 中华创伤杂志, 2018, 34(4): 323-330.
[4] 凌健, 尚希福. 改良Stoppa入路与髂腹股沟入路治疗骨盆髋臼骨折的疗效比较[J]. 中国矫形外科杂志, 2017, 25(24): 2286-2289.
[5] 黄伟奇, 杨晓东, 李涛. 骶髂关节周围腰骶丛神经的解剖学研究及其临床意义[J]. 中国临床解剖学杂志, 2017, 35(6): 615-617.
[6] 陈开放, 段德胜, 熊泽康, 等. 3D打印技术辅助高位髂腹股沟入路治疗复杂髋臼骨折[J]. 中华骨科杂志, 2017, 37(13): 786-792.
[7] Levesque A, Riant T, Labat JJ, et al. Use of high-concentration capsaicin patch for the treatment of pelvic pain: observational study of 60 inpatients[J]. Pain Physician, 2017, 20(1): E161-E167.
[8] 盛伟超, 高延征, 钟世镇. 髂骨螺钉骨性通道毗连血管及神经的解剖学研究[J]. 中国临床解剖学杂志, 2018, 36(3): 248-251.
[9] 张凤桐, 冯学武, 马建国, 等. 单一髂腹股沟入路弹性支撑固定后柱治疗复杂髋臼骨折的效果评估[J]. 中国骨与关节损伤杂志, 2018, 33(4): 48-50.
[10] Zhuang Y, Zhang K, Wang H, et al. A short buttress plate fixation of posterior column through single ilioinguinal approach for complex acetabular fractures[J]. Int Orthop, 2017, 41(1): 165-171.
[11] Dennis M, Granger A, Ortiz A, et al. The anatomy of the musculocutaneous latissimus dorsi flap for neophalloplasty[J]. Clin Anat, 2017, 31(2): 152-159.
[12] 宋虎, 陈龙, 施建国, 等. 3D导航辅助下经皮骶髂螺钉联合前环外固定架治疗TileB、C型骨盆骨折[J]. 中华创伤杂志, 2018, 34(6): 497-504.
[13] Verbeek DO, Ponsen KJ, van Heijl M, et al. Modified Stoppa approach for operative treatment of acetabular fractures: 10-year experience and mid-term follow-up[J]. Injury, 2018, 49(6): 1137-1140.
[14] Zhang BF, Zhang H, Wang PF, et al. The role of ultrasonography in examination of the stability of Tile-B2 pelvic fractures[J]. Medicine, 2017, 96(38): e8100.
[15] 陈开放, 杨帆, 郭晓东, 等. 髋臼四方区组合钢板治疗髋臼双柱骨折[J]. 中华骨科杂志, 2018, 38(3): 295-300.
[16] Gras F, Marintschev I, Grossterlinden L, et al. The anterior intra-pelvic approach for acetabular fractures utilizing approach specific instruments and an antatomical-preshaped, three dimensional suprapectineal plate[J]. J Orthop Trauma, 2017, 12(3): 12-14.
[17] Chen K, Ji Y, Huang Z, et al. Single modified ilioinguinal approach for the treatment of acetabular fractures involving both columns[J]. J Orthop Trauma, 2018, 32(11): e428-e434.