摘要
目的研究经腹直肌外侧入路(PRA)治疗垂直剪切型骨盆骨折合并腰骶丛神经损伤的临床疗效.方法选取2017年1月—2019年5月本院收治的61例垂直剪切型骨盆骨折合并腰骶丛神经损伤患者.所有受试者均接受PRA治疗.分析患者围术期结果,术后肌力恢复情况,术后并发症发生情况,手术前后心理状态以及生活质量.结果末次随访显示,所有患者运动功能相较于术前提高0~4个等级,平均2.9个等级.患者术后伤口均一期愈合,无1例臀部感觉、运动异常,未出现神经损伤加剧、下肢深静脉血栓、股神经损伤等并发症,1例术后尿液外渗,导尿2周后膀胱自行修复,痊愈出院.术后焦虑自评量表以及抑郁自评量表评分均低于术前,差异有统计学意义(P<0.05).术后各项健康调查简表评分均高于术前,差异有统计学意义(P<0.05).结论对垂直剪切型骨盆骨折合并腰骶丛神经损伤患者开展PRA治疗,可获得理想疗效,促进肌力恢复,术后并发症风险较低,且能改善心理状况和生活质量.
Objective To investigate the clinical efficacy of the lateral approach of rectus abdominis(PRA)in the treatment of vertical shear pelvic fracture with lumbosacral plexus nerve injury.Methods 61 patients with vertical shear pelvic fracture complicated with lumbosacral plexus nerve injury admitted to the hospital from January 2017 to May 2019 were selected.All subjects received PRA.The perioperative results,postoperative muscle strength recovery,postoperative complications,psychological status and quality of life changes before and after surgery of all patients were analyzed.Results The last follow-up results showed that the motor function of all patients improved by 0 to 4 grades compared with that before surgery,with an average of 2.9 grades.The wounds of all the patients healed in one stage after surgery,and there was no abnormal sensation and movement in buttocks,no aggravation of nerve injury,deep vein thrombosis in lower limbs,femoral nerve injury and other complications.One patient had urine extravasation after surgery,and after 2 weeks of indwelling catheter catheterization,the bladder repaired itself and was discharged.The scores of self-rating anxiety scale and self-rating depression scale were lower than those before surgery,the differences were statistically significant(P<0.05).The MOS item short from health survey score after surgery was higher than that before surgery,the difference was statistically significant(P<0.05).Conclusion PRA therapy for patients with vertical shear pelvic fracture complicated with lumbosacral plexus nerve injury can achieve ideal efficacy,promote the recovery of muscle strength,reduce the risk of postoperative complications,and improve psychological status and quality of life.
作者
李泳高
马俭凡
张昊
罗健波
萧勇钿
LI Yonggao;MA Jianfan;ZHANG Hao;LUO Jianbo;XIAO Yongdian(The Second Department of Orthopedics,Taishan People's Hospital,Taishan Guangdong,529200,China)
出处
《反射疗法与康复医学》
2021年第20期44-46,50,共4页
Reflexology And Rehabilitation Medicine
关键词
骨盆骨折
腰骶丛神经损伤
经腹直肌外侧入路
临床疗效
Pelvic fracture
Lumbosacral plexus nerve injury
Approach via lateral rectus abdominis
Clinical curative effect
