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骨盆骨折后环损伤的诊断及治疗研究进展

Advances in Diagnosis and Treatment of Posterior Distal Injury of Pelvic Fracture

作者:谭振, 王光林

Author:TAN Zhen, WANG Guang-lin

收稿日期:          年卷(期)页码:2017,48(5):655-660

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:骨盆骨折后环损伤 骶髂关节脱位 骶髂螺钉 微创 不稳定型骶骨骨折 周围神经损伤

Key words:Pelvic fracture after ring injury Sacroiliac joint dislocation Sacroiliac screw Minimally invasive Unstable sacral fracture Peripheral nerve injury

基金项目:

中文摘要

骨盆骨折是创伤骨科常见疾病之一,随着我国交通事故、高坠伤、挤压伤等事故的不断增加,骨盆骨折的发病率也逐年升高。由于骨盆的骨及韧带结构与盆腔、神经血管、空腔脏器及泌尿生殖结构紧密相邻,所以骨盆骨折的早期诊断及治疗是预防骨盆骨折早期并发症及晚期后遗症的主要手段。骨盆后环损伤的治疗一直是骨盆骨折治疗的重点。骨盆后环损伤的治疗主要采用外固定和内固定治疗,其适应症仍是骨盆骨折治疗的争论焦点,但对于不稳定型骨盆后环损伤,急诊行外固定治疗在急诊抢救中起到非常重要的作用。骨盆后环损伤常伴有神经损伤(腰骶丛神经损伤),其常导致疼痛、功能障碍等并发症的发生,由于其难治性,学者们对其展开了大量的基础研究,以期从基础研究获得临床创新的成功,从而在一定程度上修复神经损伤,降低骨盆后环损伤引起的并发症。因此,在创伤骨科规范诊疗的基础上,关注和应用这些进展,适时开展基础和临床研究,能提高骨盆骨折的诊治水平,达到更好为患者诊治、改善生存和预后的目的。

英文摘要

【Abstract】 Pelvic fracture is one of the common diseases of traumatic orthopedics. With the increase of accidents such as traffic accidents, high craters and crush injuries in China, the incidence of pelvic fractures is also increasing year by year. Since pelvic bones and the ligament structure are close to neurovascular, cavity organs and the urogenital structure, early diagnosis and treatment of pelvic fractures is essential for preventing early complications and late sequelae. The treatment of pelvic ring injury has been the focus of pelvic fracture treatment, which determines the outcome of treatment. The application of external fixation and internal fixation to pelvic fracture is still subject to ongoing debate. For unstable pelvic ring injury, emergency external fixation plays a very important role. Pelvic ring injury is often accompanied with nerve injury (lumbosacral plexus injury), which often leads to pain, dysfunction and other complications. Because of its refractory, extensive studies have been undertaken to identify clinical innovations that may be able to repair nerve damage and reduce complications. These research advances can help improve the diagnosis and treatment of pelvic fractures and patient survival and prognosis.

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