摘要目的:评价经髂腹股沟联合Kocher-Langenbeck(K-L)入路治疗复杂髋臼骨折的效果。方法:收集我院2018年1月至2020年6月收治的复杂髋臼骨折患者75例的临床资料,按照两种不同的手术入路方式分为观察组[经髂腹股沟联合Kocher-Langenbeck(K-L)入路]38例和对照组(K-L入路)37例。两组患者均随访一年,使用Matta影像学评定观察术后骨折复位情况评价临床疗效,比较两组术后并发症(异位骨化、骨性关节炎、股骨头缺血坏死、神经血管损伤等)的发生情况,采用Merle d,Aubigne和Postel评分系统评价患者髋关节功能情况,使用Barthel指数(BI)和健康调查简表(the MOS item short from health survey,SF-36)对患者髋关节功能和生活质量进行评定。结果:①临床疗效:两组患者的临床有效率分别为94.74%和75.68%,观察组高于对照组,差异具有统计学意义(P<0.05),观察组疗效等级优于对照组(P<0.05)。②并发症发生率:两组术后并发症发生率分别为7.89%和27.03%,观察组明显低于对照组,差异具有统计学意义(P<0.05)。③髋关节功能:观察组患者髋关节功能评分各维度及总分治疗后与治疗前差值均高于对照组(P<0.01)。④日常生活能力和生活质量:观察组患者BI和SF-36治疗后与治疗前差值比较均高于对照组(P<0.01)。结论:经髂腹股沟联合K-L入路治疗复杂髋臼骨折的临床疗效和安全性均较好,术后并发症少,可以改善患者髋关节功能提高日常生活能力和生活质量。
Abstract：Objective: To evaluate the effect of combined ilioinguinal and Kocher-Langenbeck (K-L) approach in the treatment of complex acetabular fractures. Methods: The clinical data of 75 patients with complex acetabular fractures admitted to the hospital between January 2018 and June 2020 were collected , and the patients were divided into observation group (combined ilioinguinal and K-L approach, 38 cases) and control group (KL approach, 37 cases) according to the two different surgical approaches. The two groups of patients were followed up for 1 year, and Matta imaging was used to evaluate and observe the postoperative fracture reduction and evaluate the clinical efficacy. The occurrence of postoperative complications (heterotopic ossification, osteoarthritis, avascular necrosis of the femoral head, neurovascular injury) were compared between the two groups. Merle d’ Aubigne and Postel scoring system was used to evaluate the hip function, and Barthel index (BI) and the MOS item short from health survey (SF-36) were applied to assess the hip function and quality of life of patients. Results: ① In terms of clinical efficacy, the 94.74% clinical effective rate in observation group was higher than 75.68% in control group (P<0.05), and the efficacy grading in observation group was better than that in control group (P<0.05). ② The incidence rate of postoperative complications was 7.89% in observation group, which was significantly lower than 27.03% in control group (P<0.05). ③ In terms of hip function, the differences of the above-mentioned scores after treatment and before treatment in observation group were higher than those in control group (P<0.01). ④ From the aspects of ability of daily living and quality of life, the differences of scores of BI and SF-36 after treatment and before treatmentwere were higher in observation group compared to control group (P<0.01). Conclusion: Combined ilioinguinal and K-L approach has good clinical efficacy and safety and few postoperative complications in the treatment of complex acetabular fractures, and can improve the hip function and enhance the ability of daily living and quality of life.
杨小中, 邓章云, 胡松. 经髂腹股沟联合Kocher-Langenbeck(K-L)入路治疗复杂髋臼骨折的临床疗效及安全性分析[J]. 河北医学, 2022, 28(3): 432-436.
YANG Xiaozhong, DENG Zhangyun, HU Song. Clinical Efficacy and Safety Analysis of the Combined Kocher-Langenbeck (K-L) Approach for Complex Acetabular Fractures via the Ilioinguinal Groin. HeBei Med, 2022, 28(3): 432-436.
2022, Vol. 28 
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