椎弓根钉棒系统治疗骨盆骨折与骶髂关节前路钢板内固定治疗不稳定骨盆骨折的效果观察

doi:10.3969/j.issn.1006-6233.2020.11.018

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摘要 目的: 探究椎弓根钉棒系统治疗骨盆骨折与骶髂关节前路钢板内固定治疗不稳定骨盆骨折的效果观察。方法: 分析2015年8月至2019年12月在我院收治的骨盆骨折患者90例为研究对象,基于随机数字表简单随机分为对照组与观察组,各45例。其中对照组行骶髂关节前路钢板内固定治疗,观察组患者行椎弓根钉棒系统治疗。比较不同治疗方法下两组患者的治疗疗效及骨盆复位情况。结果: 观察组患者的手术时间、出血量、手术切口、负重时间及下床时间均低于对照组,组间差异具有统计学意义(P<0.05)。重复测量结果显示,两组患者治疗后不同时间VAS评分呈降低趋势。且观察组术后1、2、3周的VAS评分均低于对照组,差异具有统计学意义(P<0.05)。治疗后观察组患者的骨折复位优良率为91.11%,对照组为75.56%,差异具有统计学意义(Z=-3.847,χ²=3.920,P<0.05)。广义估计方程分析显示,观察组患者不同时点功能康复优良率均高于对照组(Waldχ²_组别=4.639,Waldχ²_时点=70.734,P_组别=0.031,P_时点<0.001)。术后观察组并发症发生率为2.22%(1/45),无感染发生,对照组为17.78%(8/45),差异不具有统计学意义(χ²=6.049,P<0.05)。结论: 椎弓根钉棒系统治疗骨盆骨折患者疗效显著,其不仅可为患者提供稳定的力学结构,促进患者术后康复,且其术后并发症发生率低,值得临床推广使用。

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	黄伟
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关键词 ：骨盆骨折, 不稳定骨盆骨折, 椎弓根钉棒系统治疗, 骶髂关节前路钢板内固定治疗

Abstract：Objective: To investigate the effects of pedicle screw system in the treatment of pelvic fractures and anterior sacroiliac joint plate internal fixation in the treatment of unstable pelvic fractures.Methods: 90 patients with pelvic fracture admitted to our hospital from August 2015 to December 2019 were selected as the research objects,and they were randomly divided into control group and observation group,45 cases in each group.The control group was treated with anterior plate fixation of sacroiliac joint,and the observation group was treated with pedicle screw rod system.The therapeutic effect and pelvic reduction of the two groups were compared under different treatment methods.Results: The operation time,blood loss,surgical incision,load and ambulation time in the observation group were lower than those in the control group,and the difference between the two groups was statistically significant (P<0.05).Repeated measurement results showed that the VAS scores of the two groups decreased at different time after treatment.The VAS scores of the observation group at 1,2 and 3 weeks after operation were lower than those of the control group (P<0.05).After treatment,the excellent and good rate of fracture reduction was 91.11% in the observation group and 75.56% in the control group,the difference was statistically significant (z = -3.847,χ ² = 3.920,P<0.05).Generalized estimation equation analysis showed that the excellent and good rate of functional rehabilitation in the observation group was higher than that in the control group at different time points (Wald χ2 group = 4.639,Wald χ ² time point = 70.734,P group = 0.031,P time point <0.001).The incidence of postoperative complications in the observation group was 2.22% (1 / 45),and there was no infection in the control group (17.78%) (χ ² = 6.049,P<0.05).Conclusion: The pedicle screw system is effective in the treatment of patients with pelvic fractures.It not only provides stable mechanical structure for patients and promotes their postoperative recovery,but also has a low incidence of postoperative complications,which is worthy of clinical application.

Key words： Pelvic fractures Unstable pelvic fractures Pedicle screw system treatment Internal fixation with anterior sacroiliac joint plate

基金资助:江苏省自然科学基金项目,(编号:BK20140960)

通讯作者: 尹毅

引用本文:

黄伟, 金晔, 单辉强, 尹毅. 椎弓根钉棒系统治疗骨盆骨折与骶髂关节前路钢板内固定治疗不稳定骨盆骨折的效果观察[J]. 河北医学, 2020, 26(11): 1836-1841.
HUANG Wei, JIN Ye, SHAN Huiqiang, et al. Effect of Pedicle Screw Rod System in the Treatment of Pelvic Fractures and Anterior Sacral Iliac Joint Plate Fixation in the Treatment of Unstable Pelvic Fractures. HeBei Med, 2020, 26(11): 1836-1841.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.11.018 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I11/1836