| 摘要: |
| ［摘要］ 目的 观察经腹直肌外侧小切口入路治疗骨盆髋臼骨折的效果。方法 回顾性分析2021年4月至2023年12月华中科技大学同济医学院附属同济医院收治的86例骨盆髋臼骨折患者的临床资料，根据治疗方案不同将其分为观察组（采用经腹直肌外侧小切口入路）和对照组（采用髂腹股沟入路），各43例。比较两组围术期指标、手术应激指标、骨折复位满意率、Majeed骨盆功能评分以及并发症发生情况。结果 观察组显露骨折端时间、手术时间、住院时间短于对照组，术中失血量少于对照组，差异有统计学意义（P<0.05）。观察组术后第1天皮质醇（Cor）、去甲肾上腺素（NE）水平显著低于对照组（P<0.05）。观察组骨折复位满意率显著高于对照组（88.37% vs 69.77%； χ2=4.497，P=0.034）。两组术后Majeed骨盆功能评分均呈上升趋势（P<0.05），观察组术后第3个月Majeed骨盆功能评分显著高于对照组（P<0.05），两组术后第6个月和术后第12个月的Majeed骨盆功能评分比较差异无统计学意义（P>0.05）。观察组并发症总发生率显著低于对照组（4.65% vs 23.26%； χ2=6.198，P=0.013）。结论 与髂腹股沟入路相比，经腹直肌外侧小切口入路在治疗骨盆髋臼骨折时具有创伤性更小、术后康复更快的优点，可提高术后复位满意率，有利于患者早期骨盆功能恢复，且术后并发症更少，值得临床推荐。 |
| 关键词: 经腹直肌外侧小切口入路 髂腹股沟入路 骨盆髋臼骨折 应激反应 骨盆功能 |
| DOI：10.3969/j.issn.1674-3806.2026.03.11 |
| 分类号:R 683.3 |
| 基金项目:国家重点研发计划项目（编号：2022YFC2504303） |
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| Observation on the effect of treating pelvic acetabular fractures by small incision approach via the lateral rectus abdominis muscle |
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CHENG Ruixiang1,2, HE Li2, YI Chengla2
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1.Department of Trauma Surgery, the Second People′s Hospital of Beihai, Beihai 536000, China; 2.Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
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| Abstract: |
| ［Abstract］ Objective To observe the effect of treating pelvic acetabular fractures by small incision approach via the lateral rectus abdominis muscle. Methods A retrospective analysis was conducted on the clinical data of 86 patients with pelvic acetabular fractures who were admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from April 2021 to December 2023. According to different treatment regimens, the patients were divided into observation group(adopting small incision approach via the lateral rectus abdominis muscle) and control group(adopting ilioinguinal approach), with 43 patients in each group. The perioperative indicators, surgical stress indicators, rate of satisfaction with fracture reduction, Majeed Pelvic Scores and the occurrence of complications were compared between the two groups. Results Compared with the control group, the observation group had shorter time of fracture end exposure, duration of operation and hospital stay, and less intraoperative blood loss, with statistically significant differences between the two groups(P<0.05). On the first day after the operation, the levels of cortisol(Cor) and norepinephrine(NE) in the observation group were significantly lower than those in the control group(P<0.05). The rate of satisfaction with fracture reduction in the observation group was significantly higher than that in the control group(88.37% vs 69.77%; χ2=4.497, P=0.034). The postoperative Majeed Pelvic Scores in both groups showed an upward trend(P<0.05). The Majeed Pelvic Scores in the observation group at the 3rd month after operation were significantly higher than those in the control group(P<0.05), while there were no significant differences in the Majeed Pelvic Scores between the two groups at the 6th month and 12th month after operation(P>0.05). The total incidence of complications in the observation group was lower than that in the control group(4.65% vs 23.26%; χ2=6.198, P=0.013). Conclusion Compared with the operation by ilioinguinal approach, the operation by small incision approach via the lateral rectus abdominis muscle has the advantages of less trauma and faster postoperative recovery in treating pelvic acetabular fractures, can enhance the rate of satisfaction with fracture reduction, and is beneficial to the recovery of the patient′s early pelvic floor function, with less postoperative complications, and is worthy of clinical recommendation. |
| Key words: Small incision approach via the lateral rectus abdominis muscle Ilioinguinal approach Pelvic acetabular fractures Stress response Pelvic floor function |
