中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2009年
24期
1892-1895
,共4页
祁磊%桑锡光%李牧%李玉华
祁磊%桑錫光%李牧%李玉華
기뢰%상석광%리목%리옥화
腰骶部%骨盆%创伤和损伤%骨折固定术
腰骶部%骨盆%創傷和損傷%骨摺固定術
요저부%골분%창상화손상%골절고정술
Lumbosacral region%Pelvis%Wounds and injuries%Fracture fixation
目的 探讨创伤性腰骶盆损伤的特征及外科治疗方法.方法 回顾性分析2005年8月至2008年2月救治的8例创伤性腰骶盆损伤患者的临床资料.其中男性6例,女性2例;年龄21-52岁,平均38.4岁.对所有患者创伤严重程度进行ISS评分,神经损伤根据ASIA评分进行评价.先处理影响生命的紧急情况,待病情稳定后行腰椎-髂骨内固定术.术后常规影像学检查,观察患者骨折复位情况,并对患者术后神经功能情况进行ASIA评分,对术前和末次随访时ASIA评分进行统计学分析.结果 所有患者均获随访,随访时间9～25个月,平均16.9个月.术后影像学显示骨折复位满意,术前ASIA感觉和运动评分分别为35.8 ±5.3和31.9±6.4,末次随访时ASIA感觉和运动评分为51.8±13.8和38.2±7.5,感觉和运动功能较术前有明显的改善(P<0.01).术后6例患者大小便功能有不同程度的恢复.本组术后未出现神经损伤加重病例.结论 创伤性腰骶盆损伤是腰骶盆区的严重损伤,采用腰椎-髂骨内固定术有助于骨折复位稳定,临床疗效较好.
目的 探討創傷性腰骶盆損傷的特徵及外科治療方法.方法 迴顧性分析2005年8月至2008年2月救治的8例創傷性腰骶盆損傷患者的臨床資料.其中男性6例,女性2例;年齡21-52歲,平均38.4歲.對所有患者創傷嚴重程度進行ISS評分,神經損傷根據ASIA評分進行評價.先處理影響生命的緊急情況,待病情穩定後行腰椎-髂骨內固定術.術後常規影像學檢查,觀察患者骨摺複位情況,併對患者術後神經功能情況進行ASIA評分,對術前和末次隨訪時ASIA評分進行統計學分析.結果 所有患者均穫隨訪,隨訪時間9～25箇月,平均16.9箇月.術後影像學顯示骨摺複位滿意,術前ASIA感覺和運動評分分彆為35.8 ±5.3和31.9±6.4,末次隨訪時ASIA感覺和運動評分為51.8±13.8和38.2±7.5,感覺和運動功能較術前有明顯的改善(P<0.01).術後6例患者大小便功能有不同程度的恢複.本組術後未齣現神經損傷加重病例.結論 創傷性腰骶盆損傷是腰骶盆區的嚴重損傷,採用腰椎-髂骨內固定術有助于骨摺複位穩定,臨床療效較好.
목적 탐토창상성요저분손상적특정급외과치료방법.방법 회고성분석2005년8월지2008년2월구치적8례창상성요저분손상환자적림상자료.기중남성6례,녀성2례;년령21-52세,평균38.4세.대소유환자창상엄중정도진행ISS평분,신경손상근거ASIA평분진행평개.선처리영향생명적긴급정황,대병정은정후행요추-가골내고정술.술후상규영상학검사,관찰환자골절복위정황,병대환자술후신경공능정황진행ASIA평분,대술전화말차수방시ASIA평분진행통계학분석.결과 소유환자균획수방,수방시간9～25개월,평균16.9개월.술후영상학현시골절복위만의,술전ASIA감각화운동평분분별위35.8 ±5.3화31.9±6.4,말차수방시ASIA감각화운동평분위51.8±13.8화38.2±7.5,감각화운동공능교술전유명현적개선(P<0.01).술후6례환자대소편공능유불동정도적회복.본조술후미출현신경손상가중병례.결론 창상성요저분손상시요저분구적엄중손상,채용요추-가골내고정술유조우골절복위은정,림상료효교호.
Objective To study the characteristic and surgical treatment of traumatic lumbosacropelvic injuries. Methods A retrospective study was carried out on 8 cases with traumatic lumbosacropelvic injuries between August 2005 and February 2008, which included 6 male and 2 female, aged from 21 to 52 years with a mean age of 38.4 yeas. ISS scores were undertaken to evaluate the injury severity of the cases after admission. Measures were taken to treat the emergency that affected the patients' lives. After the patients' conditions were stable, lumboiliac fixation was performed to treat traumatic lumbosacropelvic injuries. Imaging examinations were made to observe the reduction of fracture after operation. Injury of nerve was evaluated with ASIA score, and ASIA scores of preoperation and the last follow-up were analyzed statistically with pared t test Results The group was followed up for 9 to 25 months, averaging 16. 9 months. Postoperative imaging examinations showed satisfied reduction of fracture. The preoperative ASIA sensory score and motor score were 35. 8 ±5. 3 and 31. 9 ±6. 4 respectively, while the sensory score and motor score were 51. 8 ± 13. 8 and 38. 2 ±7. 5 at the last follow-up respectively. The sensory and motor functions were improved significantly after operation ( P < 0. 01 ) . The functions of urination and defecation of 6 cases were recovered for different degree after operation. In all of the cases, no aggravated injury of nerve occurred. Conclusions Traumatic lumbosacropelvic injuries is a kind of severe injury of lumbosacropelvic region. It can be treated with lumboiliac internal fixation and fine clinical effect can be gained.
