【摘要】：研究目的:探討不完全性半骨盆離斷傷的急救策略;制定不完全性半骨盆離斷傷評(píng)估表,探討其對(duì)指導(dǎo)治療不完全性半骨盆離斷傷的價(jià)值。研究方法:回顧性分析2003年1月至2015年12月,治療14例不完全性半骨盆離斷傷患者資料,男10例,女4例;年齡21～55歲,平均31歲;11例為急診入院,3例為外院轉(zhuǎn)入;Tile分型均為C型骨盆骨折,其中C1型9例,C2型3例,C3型2例。根據(jù)患者軟組織的損傷程度、骨性結(jié)構(gòu)離中軸距離、髂血管損傷程度以及神經(jīng)損傷程度四項(xiàng)標(biāo)準(zhǔn)對(duì)患者進(jìn)行傷情評(píng)估,每一項(xiàng)評(píng)估標(biāo)準(zhǔn)按損傷程度分為四級(jí),分別對(duì)應(yīng)1～4分,總分16分,制定半骨盆離斷傷評(píng)估量表;其中評(píng)分12分,則立即行半骨盆離斷術(shù);8評(píng)分≤12分,則根據(jù)實(shí)際情況再次評(píng)估,并建議行半骨盆離斷術(shù);4評(píng)分≤8分,則盡力保肢;評(píng)分≤4分,則絕對(duì)保肢。研究結(jié)果:14例患者按半骨盆離斷評(píng)估量表進(jìn)行評(píng)價(jià),評(píng)分為9～15分,平均11分;其中9～12分12例,超過(guò)12分2例,均應(yīng)行半骨盆離斷術(shù)。14例患者中,3例在急救復(fù)蘇階段死亡;7例在出血得到控制后,早期行半骨盆離斷術(shù),全部搶救成功;4例嘗試保肢或保留半側(cè)骨盆,其中3例因感染而死亡,1例在一期半髖離斷術(shù)后第3天因感染而二期行半骨盆離斷術(shù),術(shù)后存活。研究結(jié)論:半骨盆離斷傷評(píng)估量表可以早期迅速、準(zhǔn)確地對(duì)不完全半骨盆離斷傷進(jìn)行評(píng)估,明確診斷,有助于指導(dǎo)急救流程;在休克得到控制后,早期進(jìn)行半骨盆離斷術(shù),可以提高急救的成功率。
[Abstract]:Objective: to explore the first aid strategy of incomplete hemipelvic dissection, to establish the evaluation table of incomplete hemipelvic fracture, and to explore its value in guiding the treatment of incomplete hemipelvic fracture. Methods: from January 2003 to December 2015, 14 patients (10 males and 4 females) with incomplete hemipelvic dissection were retrospectively analyzed. The average age was 31 years, 11 cases were admitted to emergency department, 3 cases were transferred to external hospital, 9 cases were type C1, 3 cases were type C2 and 2 cases were type C3. According to the degree of soft tissue injury, the distance of bone structure from the central axis, the degree of injury of iliac blood vessel and the degree of nerve injury, the patients were evaluated according to the degree of injury, each of which was divided into four levels according to the degree of injury. The scale for evaluation of hemipelvis disconnection injury was formulated with a score of 1 ~ 4, with a total score of 16 points, in which 12 points were scored, half pelvic dissection was performed immediately, and 8 points 鈮，

本文編號(hào)：2271428