摘要
目的探讨应用多普勒超声评估侧方挤压-1(LC-1)型骨盆骨折骨盆环的稳定性及其临床意义。方法前瞻性招募2016年7月至2017年11月期间西安交通大学医学院附属红会医院创伤骨科环骨盆病区收治的38例LC-1型骨盆骨折患者。男22例,女16例;年龄为(55.2±16.1)岁。待患者病情平稳后进行骨盆挤压分离试验下的超声检查。按照我们建立的标准:将左右侧活动度≥0.3 cm者归为不稳定组(16例),活动度<0.3 cm者归为稳定组(22例)。稳定组患者采用保守治疗,不稳定组患者采用手术治疗。记录并比较两组患者的骨折断端活动度、随访时间、下地负重时间、骨折愈合时间及末次随访时Majeed骨盆功能评分等。结果两组患者的临床基线情况比较差异均无统计学意义(P>0.05),具有可比性。不稳定组患者的骨折断端活动度[左右径、前后径、斜径分别为(0.45±0.22)、(0.26±0.16)、(0.50±0.23)cm]显著大于稳定组患者[(0.11±0.03)、(0.05±0.04)、(0.11±0.07)cm],差异均有统计学意义(P<0.05)。稳定组患者的下地负重时间[(0.9±0.5)个月]显著早于不稳定组患者[(1.9±2.0)个月],差异有统计学意义(Z=-2.353,P=0.019)。而稳定组与不稳定组患者的随访时间[(13.9±3.8)、(15.1±3.0)个月]、骨折愈合时间[(4.6±1.3)、(4.5±1.2)个月]、Mejeed骨盆功能评分[(84.8±6.4)、(80.3±12.2)分]比较差异均无统计学意义(P>0.05)。结论多普勒超声检查有助于判断LC-1型骨盆骨折的稳定性:稳定骨折采用保守治疗,不稳定骨折早期采用手术治疗,均可取得良好疗效。
Objective To explore the application of Doppler ultrasound to assess the stability of pelvic ring in treatment of lateral-compression-1(LC-1)pelvic fractures.Methods For this prospective study 38 patients with LC-1 pelvic fracture were enrolled who had been admitted to the Department of Orthopedic Trauma,Honghui Hospital from July 2016 to November 2017.They were 22 men and 16 women with an age of 55.2±16.1 years.After the patient's condition was stable,they underwent a Doppler ultrasound examination in the pelvic compression separation test.According to the criteria preset:those with a left-right mobility≥0.3 cm were assigned as an unstable group(16 cases)and those with a mobility<0.3 cm as a stable group(22 cases).The stable group received conservative treatment while the unstable group surgical treatment.The 2 groups were compared in terms of mobility of fracture ends,follow-up time,weight-bearing time,fracture healing time,and the Majeed scores of pelvic function at the last follow-up.Results The 2 groups were compatible due to their insignificant differences in baseline data(P>0.05).The mobility of fracture ends(left-right distance:0.45±0.22 cm;anterior-posterior distance:0.26±0.16 cm;oblique distance:0.50±0.23 cm)in the unstable group was all significantly greater than in the stable group(left-right distance:0.11±0.03 cm;anterior-posterior distance:0.05±0.04 cm;oblique distance:0.11±0.07 cm)(P<0.05).The weight-bearing time in the stable group(0.9±0.5 months)was significantly shorter than that in the unstable group(1.9±2.0 months)(Z=-2.353,P=0.019).There were no significant differences between the 2 groups in follow-up time(13.9±3.8 months versus 15.1±3.0 months),fracture healing time(4.6±1.3 months versus 4.5±1.2 months)or the Majeed scores(84.8±6.4 versus 80.3±12.2)(all P>0.05).Conclusions Since ultrasonography is helpful in assessment of the stability of LC-1 pelvic fractures,a proper treatment strategy can be decided.Stable ones can be treated conservatively and unstable ones surgically.
作者
黄海
张斌飞
张红
王鹏飞
丛雨轩
韩爽
刘萍
柯超
尚昆
王虎
张堃
庄岩
Huang Hai;Zhang Binfei;Zhang Hong;Wang Pengfei;Cong Yuxuan;Han Shuang;Liu Ping;Ke Chao;Shang Kun;Wang Hu;Zhang Kun;Zhuang Yan(Department of Orthopaedic Trauma,Honghui Hospital,Xi'an Jiaotong University,Xi'an 710054,China;Department of Ultrasound Medicine,Honghui Hospital,Xi'an Jiaotong University,Xi'an 710054,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第12期1036-1040,共5页
Chinese Journal of Orthopaedic Trauma
基金
陕西省重点研发计划项目(2017SF-050)。
关键词
骨盆
骨折
侧方挤压
超声检查
多普勒
稳定性
Pelvis
Fractures
bone
Lateral compression
Ultrasonography
doppler
Stability
