| 腹直肌旁入路与改良Stoppa入路治疗髋臼骨折的疗效比较 |
| Comparison of clinical efficacy between the pararectus approach and modified Stoppa approach in the treatment of acetabular fractures |
| 投稿时间：2021-10-18 修订日期：2022-03-02 |
| DOI： |
| 中文关键词: 髋臼骨折 腹直肌入路 Stoppa入路 |
| 英文关键词:Acetabular fracture Pararectus approach Stoppa approach |
| 基金项目:骨盆、髋臼骨折的急诊救治及微创治疗（2018XYB001） |
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| 中文摘要: |
| 目的 探讨腹直肌旁入路与改良Stoppa入路治疗髋臼骨折的临床疗效。方法 将2016年1月至2020年6月咸宁市中心医院和华中科技大学同济医学院附属同济医院收治的100例髋臼骨折患者纳入回顾性分析，选取采用腹直肌旁入路和改良Stoppa入路手术的并获得满意随访的患者各50例，比较两组间髋臼骨折分型、手术时间、术中出血量、住院时间、术后并发症发生率及末次随访髋关节功能Harris评分。结果 两组手术入路患者随访12 ～ 18个月，两种手术入路均适合治疗累及髋臼前柱为主的髋臼骨折，其骨折分型无明显统计学意义。术中出血量腹直肌旁入路明显少于Stoppa入路组（P＜0.05），术后并发症发生率低于Stoppa入路组（P＜0.05），术后末次随访髋关节功能Harris评分比较差异无统计学意义。结论 与Stoppa入路相比，腹直肌旁入路能直视髋臼前方及四边体，具有手术创伤小，手术时间短、术后并发症少的优点，尤其适用于累及髋臼前柱为主伴四边体移位的肥胖患者。 |
| 英文摘要: |
| Objective To explore the clinical efficacy of the pararectus approach and modified Stoppa approach in the treatment of acetabular fractures.Methods A total of 100 patients with acetabular fractures admitted to Xianning Central Hospital and Tongji Hospital Affiliated to Tongji Medical College from January 2016 to June 2020 were included for retrospective analysis. Patients with pararectus approach(50 cases) and modified Stoppa approach(50 cases) were studied respectively. And the results were compared based on fracture types, operation time, intraoperative blood loss, hospital stay,postoperative complications and Harris score of hip joint function at the last follow-up.Results The two groups of patients were followed up for 12-18 months. Both surgical approaches were suitable for the treatment of acetabular fractures that mainly involve the acetabular fractures dominated by anterior column. There was no significant statistical significance in the fracture classification of the two surgical approaches. The amount of intraoperative bleeding in the pararectus abdominis approach group was significantly less than that in the Stoppa approach group (P<0.05), and the incidence of postoperative complications was lower than that in the Stoppa approach group (P<0.05). However, there was no significant difference in Harris score of hip function between the two groups at the last follow-up after surgery.Conclusion Compared with Stoppa approach, doctors can directly observe the anterior acetabulum and quadrilateral plate during the implementation of the pararectus approach. This operation method has the advantages of less surgical trauma, short operation time and less postoperative complications. It is especially suitable for the obese patients involving the anterior column of the acetabulum fracture with quadrilateral plate displacement. |
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