在骨盆环骨折中进行手术或保守治疗,骨环骨折涉及圣座
Dimitris Dalos1, Dario Guttowski2, Darius M Thiesen3
1Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; UKE Athleticum, Center for Athletic Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; Institute of Interdisciplinary Exercise Science and Sports Medicine, Faculty of Medicine, MSH, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany.
Orthopaedics & traumatology, surgery & research : OTSR
|September 23, 2023
概括
骨盆环骨折的保守治疗与神圣参与产生类似的外科手术的临床结果. 然而,手术治疗与明显较低的死亡率有关,这在患者管理中需要仔细考虑.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理的护理人员.
- 临床结果研究研究的临床结果.
背景情况:
- 骨盆环骨折与神经关节的参与提出了复杂的管理挑战.
- 评估保守治疗与手术治疗对优化患者的治疗结果至关重要.
- 日常生活活动 (ADL),疼痛水平,死亡率和并发症是关键绩效指标.
研究的目的:
- 为了比较保守管理的临床性能与骨盆环骨骨折的皮肤穿 iliosacral 螺丝固定的临床性能.
- 评估治疗组之间的ADL,疼痛,死亡率和并发症率的差异.
- 分析老年人小组的结果.
主要方法:
- 对112名骨盆环骨折患者 (46名保守,66名手术) 的回顾性研究.
- 分析包括人口统计,损伤特征,治疗类型,并发症和住院.
- 使用视觉模拟尺度 (VAS) 评估疼痛的临床结果,巴特尔尺度用于ADL,美国麻醉学会 (ASA) 评分和死亡率.
- 平均随访时间为29.3个月;老年人亚组 (n=68) 单独分析.
主要成果:
- 在VAS,巴塞尔尺度或ASA分数中,保守和操作组之间没有显著差异.
- 与操作组相比,保守组的生存率 (41.8个月) 显著较低 (55.9个月,p=0.002).
- 在老年人亚组中观察到类似的生存趋势.
结论:
- 皮肤穿透的阴螺丝固定和保守的管理显示,同等的骨盆环骨折的中期临床结果与圣参与.
- 与保守治疗相比,手术治疗显示死亡率显著降低.
- 需要进一步的前性随机研究来证实这些发现并指导临床决策.
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