中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
31期
4998-5003
,共6页
尹识渊%罗雪峰%沈明荃%谢增如
尹識淵%囉雪峰%瀋明荃%謝增如
윤식연%라설봉%침명전%사증여
植入物%骨植入物%骶髂螺钉%重建钢板%骶骨骨折%TileC型骨折%经皮%微创%对比研究%回顾性分析
植入物%骨植入物%骶髂螺釘%重建鋼闆%骶骨骨摺%TileC型骨摺%經皮%微創%對比研究%迴顧性分析
식입물%골식입물%저가라정%중건강판%저골골절%TileC형골절%경피%미창%대비연구%회고성분석
sacrum%fractures,bone%fracture fixation%surgical procedures,minimal y invasive%internal fixators%comparative study
背景：经皮骶髂螺钉内固定与经皮重建钢板内固定是近年来较流行的修复骶骨骨折的微创方法，但因缺少相关循证医学支持，临床上对于选择何种术式存在分歧。
<br> 目的：对比经皮骶髂螺钉与经皮重建钢板两种内固定方法修复TileC型骶骨骨折的效果差异。
<br> 方法：回顾性分析63例单侧TileC型骶骨骨折患者的临床资料，其中26例行经皮骶髂螺钉内固定，37例行经皮重建钢板内固定。比较两组患者手术时间、术中出血量、切口总长度、X 射线暴露次数、骨折愈合时间等方面的差异，并依据Matta标准和Majeed标准评价临床疗效。
<br> 结果与结论：63例患者均获得随访，随访时间12-36个月。两组患者在骨折愈合时间方面差异无显著性意义。经皮骶髂螺钉内固定组在术中出血量、切口总长度及临床疗效方面优于经皮重建钢板内固定组，但手术风险更大，对技术要求更高，适合有经验的治疗小组应用；经皮重建钢板内固定在临床疗效方面虽不如经皮骶髂螺钉内固定，但在手术时间、X射线暴露次数方面更优，且操作相对简单，便于基层医院推广。
揹景：經皮骶髂螺釘內固定與經皮重建鋼闆內固定是近年來較流行的脩複骶骨骨摺的微創方法，但因缺少相關循證醫學支持，臨床上對于選擇何種術式存在分歧。
<br> 目的：對比經皮骶髂螺釘與經皮重建鋼闆兩種內固定方法脩複TileC型骶骨骨摺的效果差異。
<br> 方法：迴顧性分析63例單側TileC型骶骨骨摺患者的臨床資料，其中26例行經皮骶髂螺釘內固定，37例行經皮重建鋼闆內固定。比較兩組患者手術時間、術中齣血量、切口總長度、X 射線暴露次數、骨摺愈閤時間等方麵的差異，併依據Matta標準和Majeed標準評價臨床療效。
<br> 結果與結論：63例患者均穫得隨訪，隨訪時間12-36箇月。兩組患者在骨摺愈閤時間方麵差異無顯著性意義。經皮骶髂螺釘內固定組在術中齣血量、切口總長度及臨床療效方麵優于經皮重建鋼闆內固定組，但手術風險更大，對技術要求更高，適閤有經驗的治療小組應用；經皮重建鋼闆內固定在臨床療效方麵雖不如經皮骶髂螺釘內固定，但在手術時間、X射線暴露次數方麵更優，且操作相對簡單，便于基層醫院推廣。
배경：경피저가라정내고정여경피중건강판내고정시근년래교류행적수복저골골절적미창방법，단인결소상관순증의학지지，림상상대우선택하충술식존재분기。
<br> 목적：대비경피저가라정여경피중건강판량충내고정방법수복TileC형저골골절적효과차이。
<br> 방법：회고성분석63례단측TileC형저골골절환자적림상자료，기중26례행경피저가라정내고정，37례행경피중건강판내고정。비교량조환자수술시간、술중출혈량、절구총장도、X 사선폭로차수、골절유합시간등방면적차이，병의거Matta표준화Majeed표준평개림상료효。
<br> 결과여결론：63례환자균획득수방，수방시간12-36개월。량조환자재골절유합시간방면차이무현저성의의。경피저가라정내고정조재술중출혈량、절구총장도급림상료효방면우우경피중건강판내고정조，단수술풍험경대，대기술요구경고，괄합유경험적치료소조응용；경피중건강판내고정재림상료효방면수불여경피저가라정내고정，단재수술시간、X사선폭로차수방면경우，차조작상대간단，편우기층의원추엄。
BACKGROUND:Percutaneous iliosacral screw internal fixation and percutaneous reconstruction plate internal fixation are two kinds of popular minimal y invasive surgical methods in recent years. However, due to lack of the support of related evidence-based medicine, it is controversial to choose which kind of surgical methods in the clinic.
<br> OBJECTIVE:To compare the difference for treating Tile C sacral fractures between percutaneous iliosacral screw and percutaneous reconstruction plate.
<br> METHODS:Clinical data of 63 cases of unilateral Tile C sacral fractures were retrospectively analyzed, including 26 cases of percutaneous iliosacral screw internal fixation and 37 cases of percutaneous reconstruction plate internal fixation. The data of operation time, intraoperative bleeding loss, length of incision, X-ray exposure frequency and fracture healing time were compared between both groups. The clinical efficacy was evaluated based on Matta standards and Majeed standards.
<br> RESULTS AND CONCLUSION:Al 63 patients were fol owed up for 12-36 months. No significant difference in union of fracture was detected between both groups. Intraoperative bleeding loss, length of incision, and clinical therapeutic outcomes were better in the percutaneous iliosacral screw internal fixation group than in the percutaneous reconstruction plate internal fixation group. However, percutaneous iliosacral screw internal fixation has greater surgical risk, asks for higher technology compared with percutaneous reconstruction plate internal fixation, and percutaneous iliosacral screw internal fixation suits experienced treatment team. The clinical therapeutic effects were poorer in percutaneous reconstruction plate internal fixation group than in percutaneous iliosacral screw internal fixation group, but percutaneous reconstruction plate internal fixation has shorter operative time, less X-ray exposure frequency, easier operation, and more convenient to be spread in primary hospitals.
