CAJ | 학술논문

目的：研究围产期耻骨联合分离发生的特点、发病原因、早期诊断、治疗技术和预防要点。方法对2005年1月到2012年12月治疗的31例围产期耻骨联合分离患者的临床和随访资料进行回顾性分析。结果31例患者中2例手术治疗，29例保守治疗，均随访4～6个月，平均4．5个月。患者局部症状均好转或消失，耻骨联合处无压痛，骨盆挤压分离试验阴性，产后1．5个月时分离距离和局部疼痛程度都恢复至正常水平，与治疗前相比具有显著性差异（ t值分别为1．975、2．376，均P＜0．05）。结论产前发生耻骨联合分离且胎儿较大者应首选剖宫产，以避免加重耻骨联合分离。产后型可根据临床表现及拍片检查早期诊断，积极保守治疗可获得满意效果，对于耻骨联合分离合并骶髂韧带损伤的不稳定性重度患者内固定治疗可及早进行。
목적：연구위산기치골연합분리발생적특점、발병원인、조기진단、치료기술화예방요점。방법대2005년1월도2012년12월치료적31례위산기치골연합분리환자적림상화수방자료진행회고성분석。결과31례환자중2례수술치료，29례보수치료，균수방4～6개월，평균4．5개월。환자국부증상균호전혹소실，치골연합처무압통，골분제압분리시험음성，산후1．5개월시분리거리화국부동통정도도회복지정상수평，여치료전상비구유현저성차이（ t치분별위1．975、2．376，균P＜0．05）。결론산전발생치골연합분리차태인교대자응수선부궁산，이피면가중치골연합분리。산후형가근거림상표현급박편검사조기진단，적겁보수치료가획득만의효과，대우치골연합분리합병저가인대손상적불은정성중도환자내고정치료가급조진행。
Objective To study the characteristics , pathogenesis , early diagnosis , treatment and prevention of perinatal pubic symphysis separation (PPSS).Methods Retrospective analysis was conducted on the clinical and follow-up information of 31 patients with PPSS treated in the period of January 2005 to December 2012.Results There were 2 cases undergoing operation of internal fixation , and the other 29 received conservative treatment .They were followed up after discharge for 4-6 months with average period of 4.5 months.Local symptoms relieved or disappeared , and there was no tenderness pain .Pelvic compression and separation test were negative .The separation distance and local pain degree recovered to normal 1.5 months after delivery, which were significantly different from preoperative condition (t value was 1.975 and 2.376, respectively, both P<0.05).Conclusion Prenatal occurrence of pubic symphysis separation with large fetus should choose cesarean section to avoid the aggravation of separation of symphysis pubis .Postpartum type can be diagnosed early according to clinical manifestations and X-ray examination , and active conservative treatment can obtain satisfactory effect .For patients with pubic symphysis separation combined with sacroiliac ligament injury , internal fixation can be carried out as soon as possible .